Background: Healthcare workers (HW) are a vulnerable group to develop burnout during the COVID-19... more Background: Healthcare workers (HW) are a vulnerable group to develop burnout during the COVID-19 pandemic. The aims of this study were to evaluate the perception of HW about the antibody test, and, secondarily, the prevalence of burnout and factors associated with burnout among HW who took the test.Methods: In this cross-sectional study, we evaluated burnout among HW in a 600-bed building entirely dedicated to COVID-19 inpatients care at Hospital das Clinicas (HC), located in São Paulo, Brazil. The HW answered an online questionnaire that included questions on burnout, a single-item scale based on the Maslach Burnout Inventory; demographic data, professional category, type of Protective Personal Equipment (PPE) used, distancing from social support; and emotional reactions to their serology result. Bivariate and multivariate analyses were done to evaluate the risk of burnout.Outcomes: Among 4,417 HW tested, 528 (12.0%) were positive for SARS-CoV-2 and 1,945 answered the questionnair...
Background Optimal COVID-19 management is still undefined. In this complicated scenario, the cons... more Background Optimal COVID-19 management is still undefined. In this complicated scenario, the construction of a computational model capable of extracting information from electronic medical records, correlating signs, symptoms and medical prescriptions, could improve patient management/prognosis. Methods The aim of this study is to investigate the correlation between drug prescriptions and outcome in patients with COVID-19. We extracted data from 3674 medical records of hospitalized patients: drug prescriptions, outcome, and demographics. The outcome evaluated was hospital outcome. We applied correlation analysis using a Logistic Regression algorithm for machine learning with Lasso and Matthews correlation coefficient. Results We found correlations between drugs and patient outcomes (death/discharged alive). Anticoagulants, used very frequently during all phases of the disease, were associated with good prognosis only after the first week of symptoms. Antibiotics very frequently pres...
Infection Control & Hospital Epidemiology, 2022
Objective:The coronavirus disease 2019 (COVID-19) pandemic has caused a global health crisis and ... more Objective:The coronavirus disease 2019 (COVID-19) pandemic has caused a global health crisis and may have affected healthcare-associated infection (HAI) prevention strategies. We evaluated the impact of the COVID-19 pandemic on HAI incidence in Brazilian intensive care units (ICUs).Methods:In this ecological study, we compared adult patients admitted to the ICU from April through June 2020 (pandemic period) with the same period in 2019 (prepandemic period) in 21 Brazilian hospitals. We used the Wilcoxon signed rank-sum test in a pairwise analysis to compare the following differences between the pandemic and the prepandemic periods: microbiologically confirmed central-line–associated bloodstream infection (CLABSI) and ventilator-associated pneumonia (VAP) incidence density (cases per 1,000 central line and ventilator days, respectively), the proportion of organisms that caused HAI, and antibiotic consumption (DDD).Results:We detected a significant increase in median CLABSI incidence ...
Background Although the risk of SARS-CoV-2 transmission within hospitals has been well recognized... more Background Although the risk of SARS-CoV-2 transmission within hospitals has been well recognized, there is a paucity of data on its occurrence. Our aim was to report the incidence of hospital-acquired (HA) COVID-19 at Brazilian hospitals. Methods We investigated the incidence of HA COVID-19 in Brazilian hospitals using data from a national surveillance system, from August 2020 through September 2021. Definitions of HA COVID-19 were: I-symptom onset >14 after hospital admission plus a positive SARS-CoV-2 RNA or antigen test; II-symptom onset on days 8-14 after admission, plus a positive SARS-CoV-2 RNA or antigen test positive, plus documented high-risk exposure. We performed descriptive analyses and reported HA COVID-19 rates using pooled mean and percentile distribution. Results 48,634 cases of HA COVID-19 were reported from 1,428 hospitals. Incidence ranged from 0.16/1000 patients-days at neonatal ICUs until 5.8/1000 patients-days at adults ICUs. The highest incidence of HA COVID-19 was during the months March to July 2021, similar of what was observed for community-acquired COVID-19. Conclusions This report provides a national view of the burden of HA COVID-19. The highest incidence of HA COVID-19 similar of what was observed of community-acquired. We believe that this reflects the difficulty of implementing preventive measures. Further studies evaluating risk factors for the hospital transmission of SARS-Cov-2 should clarify strategies to minimize the risk of HA COVID-19 and may be applicable to other respiratory diseases. Furthermore, the implementation of a national system to evaluate HA COVID-19 has the potential to turn this problem visible and lead to interventions in each hospital.
IntroductionAn ongoing outbreak of yellow fever (YF) has been reported in Brazil with 1261 confir... more IntroductionAn ongoing outbreak of yellow fever (YF) has been reported in Brazil with 1261 confirmed cases and 409 deaths since July 2017. To date, there is no specific treatment available for YF. Recently published papers describing in vitro and animal models suggest a potential effect of antiviral drugs (approved for the treatment of hepatitis virus) against flaviviruses, including YF. The primary aim of this study is to analyse the effect of sofosbuvir on viral kinetics and clinical outcomes among patients presenting with YF. This is a multicentre open-label randomised controlled trial with 1:1 individual allocation, stratified by severity and by recruiting centre.Methods and analysisAdults with suspected or confirmed YF infection and symptoms lasting up to 15 days are screened. Eligible and consenting patients are randomised to receive oral sofosbuvir 400 mg daily for 10 days or to receive standard clinical care. Viral kinetics are measured daily and the reduction in YF plasma v...
BackgroundCoronaVac, a vaccine containing inactivated SARS-CoV-2, demonstrated efficacy of 50.39%... more BackgroundCoronaVac, a vaccine containing inactivated SARS-CoV-2, demonstrated efficacy of 50.39% 14 days or more after the 2nd dose.The objective of this study is to report the occurrence of symptomatic COVID-19 in a cohort of HCW vaccinated with CoronaVac and to estimate its effectiveness.MethodsCoronaVac was given to HCWs inHospital das Clinicas on 18-21 January, 2021 (epi week 3) (22,402 HCWs), and on 14-16 February, 2021 (epi week 7) (21,652 HCWs). Weekly cases of symptomatic COVID-19 were evaluated. Using the period from 2020 epi week 24 through 2021 epi week 2 (before vaccination), a Poisson regression was fit to model the HCWs with COVID-19 of the hospital, and the officially reported cases in the city of São Paulo. The predicted numbers of cases among HCWs for 2021 epi weeks 3-12 were then compared to the observed numbers of cases (after vaccination). Effectiveness was estimated for weeks 9-12 (2 to 5 weeks after the 2nd dose). 142 samples after vaccination were evaluated f...
Late-Onset Hepatitis with Yellow Fever Brazil has had 2585 confirmed cases of yellow fever during... more Late-Onset Hepatitis with Yellow Fever Brazil has had 2585 confirmed cases of yellow fever during the past 2 years. In this report, investigators from Sao Paulo describe cases of hepatitis occurrin...
The use of combined antibiotic therapy has became an option for infections caused by multidrug-re... more The use of combined antibiotic therapy has became an option for infections caused by multidrug-resistant (MDR) bacteria. Time-kill (TK) assay is the gold standard method for evaluation of in vitro synergy; however, it is a time consuming and expensive method. The purpose of this study was to evaluate in vitro synergy using ETEST and disk diffusion methods that can be used routinely in clinical microbiology laboratories. Sixty-two MDR Gram-negative clinical isolates (28 Pseudomonas aeruginosa, 20 Acinetobacter baumannii and 14 Serratia marcescens) were submitted to TK, disk approximation (DA) and MIC:MIC ratio synergy methods. Overall, the agreement between the DA and TK assays for P. aeruginosa and S. marcescens isolates ranged from 57 to 93%. MIC:MIC ratio concordance with TK ranged from 57 to 71%. The best agreement with the TK assay was observed using DA method for A. baumannii isolates for the combination of fosfomycin with meropenem (80%; k= 0,60; P= 0,003). The concordance was...
Susceptibility of ceftazidime-avibactam and in vitro synergy with meropenem were investigated usi... more Susceptibility of ceftazidime-avibactam and in vitro synergy with meropenem were investigated using disk approximation and time-kill assays against 11 multiresistant Acinetobacter baumannii isolates harboring oxacillinases and 5 Serratia marcescens isolates carrying bla KPC-2 . Ceftazidime-avibactam was very active and synergistic with meropenem against multiresistant S. marcescens isolates.
In critical burn patients, the pharmacokinetic parameters (absorption, distribution, metabolism, ... more In critical burn patients, the pharmacokinetic parameters (absorption, distribution, metabolism, and excretion) of many classes of drugs, including antibiotics, are altered. The aim of this study was to compare 2 groups of burn patients undergoing treatment for health care-associated infections with and without therapeutic drug monitoring. A retrospective analysis of a clinical intervention (ie, a before/after study) was conducted with patients with health care-associated pneumonia, burn infection, bloodstream infection, and urinary tract infection in the burn intensive care unit of a tertiary care hospital. The patients were divided into 2 groups: (1) those admitted from May 2005 to October 2008 who received conventional antimicrobial dose regimens; and (2) those admitted from November 2008 to June 2011 who received antibiotics (imipenem, meropenem, piperacillin, and vancomycin) with doses adjusted according to plasma monitoring and pharmacokinetic modeling. General characteristics...
To describe the nationwide impact of a restrictive law on over-the-counter sales of antimicrobial... more To describe the nationwide impact of a restrictive law on over-the-counter sales of antimicrobial drugs, implemented in Brazil in November 2010.Approximately 75% of the population receives healthcare from the public health system and receives free-of-charge medication if prescribed. Total sales in private pharmacies as compared with other channels of sales of oral antibiotics were evaluated in this observational study before and after the law (2008-2012). Defined daily dose per 1000 inhabitants per day (DDD/TID) was used as standard unit.In private pharmacies the effect of the restrictive law was statistically significant (P < 0.001) with an estimated decrease in DDD/TID of 1.87 (s.e. = 0.18). In addition, the trend of DDD/TID before the restrictive law was greater than after the intervention (P < 0.001). Before November 2010, the slope for the trend line was estimated as 0.08 (s.e. = 0.01) whereas after the law, the estimated slope was 0.03 (s.e. = 0.01). As for the nonpriva...
Annals of Clinical Microbiology and Antimicrobials, 2007
Background Considering the increasing use of polymyxins to treat infections due to multidrug resi... more Background Considering the increasing use of polymyxins to treat infections due to multidrug resistant Gram-negative in many countries, it is important to evaluate different susceptibility testing methods to this class of antibiotic. Methods Susceptibility of 109 carbapenem-resistant P. aeruginosa to polymyxins was tested comparing broth microdilution (reference method), disc diffusion, and Etest using the new interpretative breakpoints of Clinical and Laboratory Standards Institute. Results Twenty-nine percent of isolates belonged to endemic clone and thus, these strains were excluded of analysis. Among 78 strains evaluated, only one isolate was resistant to polymyxin B by the reference method (MIC: 8.0 μg/mL). Very major and major error rates of 1.2% and 11.5% were detected comparing polymyxin B disc diffusion with the broth microdilution (reference method). Agreement within 1 twofold dilution between Etest and the broth microdilution were 33% for polymyxin B and 79.5% for colisti...
A. BackgroundThe novel coronavirus disease (COVID-19) emerged in late 2019 has shown that researc... more A. BackgroundThe novel coronavirus disease (COVID-19) emerged in late 2019 has shown that research done with open data could be the cornerstone for overcoming the need for collaborative, optimized and urgent analysis. Although several articles have been published, identification of variables that can have correlation with positive PCR results is still a challenge. In this paper we show a concrete example of open data analysis from 910 patients attended in the hospital undergoing SARS-CoV-2 RT-PCR in three private institutions in S˜ao Paulo, Brazil.B. ResultsWe performed an exploratory analysis using principal component analysis, feature selection and predictive algorithms to test for associations between a number of laboratory test abnormalities and the SARS-CoV-2 RT-PCR result. More concretely, we found a set of 18 variables that showed some association with a positive PCR result.C. ConclusionAmong these variables elevated lactic dehydrogenase (LDH) and d-dimer were the most correla...
Background: Low MRSA colonization levels in a neonatal care facility are an expected occurrence. ... more Background: Low MRSA colonization levels in a neonatal care facility are an expected occurrence. Due to the rising levels of CA-MRSA, we promoted this research to evaluate the parturients as a potential source of MSSA and MRSA in the neonatal unit. Objective: Evaluate the prevalence of Staphylococcus aureus colonization in parturients at the moment of birth and determine factors associated with carriage. Methods: From March to August 2009, 148 parturients admitted to the Hospital das Clnicas of University of São Paulo were prospectively evaluated and swabs were taken from four different sites (nasal, oropharyngeal, anal and perineal). Swabs were transported in a Stuart medium to the laboratory and inoculated in agar manitol growth medium. Gram stain, catalase and DNase tests were performed to identify S. aureus which were further tested for methicillin resistance. Clinical and epidemiological data were obtained from the parturients and their neonates including: maternal underlying d...
Background: Healthcare workers (HW) are a vulnerable group to develop burnout during the COVID-19... more Background: Healthcare workers (HW) are a vulnerable group to develop burnout during the COVID-19 pandemic. The aims of this study were to evaluate the perception of HW about the antibody test, and, secondarily, the prevalence of burnout and factors associated with burnout among HW who took the test.Methods: In this cross-sectional study, we evaluated burnout among HW in a 600-bed building entirely dedicated to COVID-19 inpatients care at Hospital das Clinicas (HC), located in São Paulo, Brazil. The HW answered an online questionnaire that included questions on burnout, a single-item scale based on the Maslach Burnout Inventory; demographic data, professional category, type of Protective Personal Equipment (PPE) used, distancing from social support; and emotional reactions to their serology result. Bivariate and multivariate analyses were done to evaluate the risk of burnout.Outcomes: Among 4,417 HW tested, 528 (12.0%) were positive for SARS-CoV-2 and 1,945 answered the questionnair...
Background Optimal COVID-19 management is still undefined. In this complicated scenario, the cons... more Background Optimal COVID-19 management is still undefined. In this complicated scenario, the construction of a computational model capable of extracting information from electronic medical records, correlating signs, symptoms and medical prescriptions, could improve patient management/prognosis. Methods The aim of this study is to investigate the correlation between drug prescriptions and outcome in patients with COVID-19. We extracted data from 3674 medical records of hospitalized patients: drug prescriptions, outcome, and demographics. The outcome evaluated was hospital outcome. We applied correlation analysis using a Logistic Regression algorithm for machine learning with Lasso and Matthews correlation coefficient. Results We found correlations between drugs and patient outcomes (death/discharged alive). Anticoagulants, used very frequently during all phases of the disease, were associated with good prognosis only after the first week of symptoms. Antibiotics very frequently pres...
Infection Control & Hospital Epidemiology, 2022
Objective:The coronavirus disease 2019 (COVID-19) pandemic has caused a global health crisis and ... more Objective:The coronavirus disease 2019 (COVID-19) pandemic has caused a global health crisis and may have affected healthcare-associated infection (HAI) prevention strategies. We evaluated the impact of the COVID-19 pandemic on HAI incidence in Brazilian intensive care units (ICUs).Methods:In this ecological study, we compared adult patients admitted to the ICU from April through June 2020 (pandemic period) with the same period in 2019 (prepandemic period) in 21 Brazilian hospitals. We used the Wilcoxon signed rank-sum test in a pairwise analysis to compare the following differences between the pandemic and the prepandemic periods: microbiologically confirmed central-line–associated bloodstream infection (CLABSI) and ventilator-associated pneumonia (VAP) incidence density (cases per 1,000 central line and ventilator days, respectively), the proportion of organisms that caused HAI, and antibiotic consumption (DDD).Results:We detected a significant increase in median CLABSI incidence ...
Background Although the risk of SARS-CoV-2 transmission within hospitals has been well recognized... more Background Although the risk of SARS-CoV-2 transmission within hospitals has been well recognized, there is a paucity of data on its occurrence. Our aim was to report the incidence of hospital-acquired (HA) COVID-19 at Brazilian hospitals. Methods We investigated the incidence of HA COVID-19 in Brazilian hospitals using data from a national surveillance system, from August 2020 through September 2021. Definitions of HA COVID-19 were: I-symptom onset >14 after hospital admission plus a positive SARS-CoV-2 RNA or antigen test; II-symptom onset on days 8-14 after admission, plus a positive SARS-CoV-2 RNA or antigen test positive, plus documented high-risk exposure. We performed descriptive analyses and reported HA COVID-19 rates using pooled mean and percentile distribution. Results 48,634 cases of HA COVID-19 were reported from 1,428 hospitals. Incidence ranged from 0.16/1000 patients-days at neonatal ICUs until 5.8/1000 patients-days at adults ICUs. The highest incidence of HA COVID-19 was during the months March to July 2021, similar of what was observed for community-acquired COVID-19. Conclusions This report provides a national view of the burden of HA COVID-19. The highest incidence of HA COVID-19 similar of what was observed of community-acquired. We believe that this reflects the difficulty of implementing preventive measures. Further studies evaluating risk factors for the hospital transmission of SARS-Cov-2 should clarify strategies to minimize the risk of HA COVID-19 and may be applicable to other respiratory diseases. Furthermore, the implementation of a national system to evaluate HA COVID-19 has the potential to turn this problem visible and lead to interventions in each hospital.
IntroductionAn ongoing outbreak of yellow fever (YF) has been reported in Brazil with 1261 confir... more IntroductionAn ongoing outbreak of yellow fever (YF) has been reported in Brazil with 1261 confirmed cases and 409 deaths since July 2017. To date, there is no specific treatment available for YF. Recently published papers describing in vitro and animal models suggest a potential effect of antiviral drugs (approved for the treatment of hepatitis virus) against flaviviruses, including YF. The primary aim of this study is to analyse the effect of sofosbuvir on viral kinetics and clinical outcomes among patients presenting with YF. This is a multicentre open-label randomised controlled trial with 1:1 individual allocation, stratified by severity and by recruiting centre.Methods and analysisAdults with suspected or confirmed YF infection and symptoms lasting up to 15 days are screened. Eligible and consenting patients are randomised to receive oral sofosbuvir 400 mg daily for 10 days or to receive standard clinical care. Viral kinetics are measured daily and the reduction in YF plasma v...
BackgroundCoronaVac, a vaccine containing inactivated SARS-CoV-2, demonstrated efficacy of 50.39%... more BackgroundCoronaVac, a vaccine containing inactivated SARS-CoV-2, demonstrated efficacy of 50.39% 14 days or more after the 2nd dose.The objective of this study is to report the occurrence of symptomatic COVID-19 in a cohort of HCW vaccinated with CoronaVac and to estimate its effectiveness.MethodsCoronaVac was given to HCWs inHospital das Clinicas on 18-21 January, 2021 (epi week 3) (22,402 HCWs), and on 14-16 February, 2021 (epi week 7) (21,652 HCWs). Weekly cases of symptomatic COVID-19 were evaluated. Using the period from 2020 epi week 24 through 2021 epi week 2 (before vaccination), a Poisson regression was fit to model the HCWs with COVID-19 of the hospital, and the officially reported cases in the city of São Paulo. The predicted numbers of cases among HCWs for 2021 epi weeks 3-12 were then compared to the observed numbers of cases (after vaccination). Effectiveness was estimated for weeks 9-12 (2 to 5 weeks after the 2nd dose). 142 samples after vaccination were evaluated f...
Late-Onset Hepatitis with Yellow Fever Brazil has had 2585 confirmed cases of yellow fever during... more Late-Onset Hepatitis with Yellow Fever Brazil has had 2585 confirmed cases of yellow fever during the past 2 years. In this report, investigators from Sao Paulo describe cases of hepatitis occurrin...
The use of combined antibiotic therapy has became an option for infections caused by multidrug-re... more The use of combined antibiotic therapy has became an option for infections caused by multidrug-resistant (MDR) bacteria. Time-kill (TK) assay is the gold standard method for evaluation of in vitro synergy; however, it is a time consuming and expensive method. The purpose of this study was to evaluate in vitro synergy using ETEST and disk diffusion methods that can be used routinely in clinical microbiology laboratories. Sixty-two MDR Gram-negative clinical isolates (28 Pseudomonas aeruginosa, 20 Acinetobacter baumannii and 14 Serratia marcescens) were submitted to TK, disk approximation (DA) and MIC:MIC ratio synergy methods. Overall, the agreement between the DA and TK assays for P. aeruginosa and S. marcescens isolates ranged from 57 to 93%. MIC:MIC ratio concordance with TK ranged from 57 to 71%. The best agreement with the TK assay was observed using DA method for A. baumannii isolates for the combination of fosfomycin with meropenem (80%; k= 0,60; P= 0,003). The concordance was...
Susceptibility of ceftazidime-avibactam and in vitro synergy with meropenem were investigated usi... more Susceptibility of ceftazidime-avibactam and in vitro synergy with meropenem were investigated using disk approximation and time-kill assays against 11 multiresistant Acinetobacter baumannii isolates harboring oxacillinases and 5 Serratia marcescens isolates carrying bla KPC-2 . Ceftazidime-avibactam was very active and synergistic with meropenem against multiresistant S. marcescens isolates.
In critical burn patients, the pharmacokinetic parameters (absorption, distribution, metabolism, ... more In critical burn patients, the pharmacokinetic parameters (absorption, distribution, metabolism, and excretion) of many classes of drugs, including antibiotics, are altered. The aim of this study was to compare 2 groups of burn patients undergoing treatment for health care-associated infections with and without therapeutic drug monitoring. A retrospective analysis of a clinical intervention (ie, a before/after study) was conducted with patients with health care-associated pneumonia, burn infection, bloodstream infection, and urinary tract infection in the burn intensive care unit of a tertiary care hospital. The patients were divided into 2 groups: (1) those admitted from May 2005 to October 2008 who received conventional antimicrobial dose regimens; and (2) those admitted from November 2008 to June 2011 who received antibiotics (imipenem, meropenem, piperacillin, and vancomycin) with doses adjusted according to plasma monitoring and pharmacokinetic modeling. General characteristics...
To describe the nationwide impact of a restrictive law on over-the-counter sales of antimicrobial... more To describe the nationwide impact of a restrictive law on over-the-counter sales of antimicrobial drugs, implemented in Brazil in November 2010.Approximately 75% of the population receives healthcare from the public health system and receives free-of-charge medication if prescribed. Total sales in private pharmacies as compared with other channels of sales of oral antibiotics were evaluated in this observational study before and after the law (2008-2012). Defined daily dose per 1000 inhabitants per day (DDD/TID) was used as standard unit.In private pharmacies the effect of the restrictive law was statistically significant (P < 0.001) with an estimated decrease in DDD/TID of 1.87 (s.e. = 0.18). In addition, the trend of DDD/TID before the restrictive law was greater than after the intervention (P < 0.001). Before November 2010, the slope for the trend line was estimated as 0.08 (s.e. = 0.01) whereas after the law, the estimated slope was 0.03 (s.e. = 0.01). As for the nonpriva...
Annals of Clinical Microbiology and Antimicrobials, 2007
Background Considering the increasing use of polymyxins to treat infections due to multidrug resi... more Background Considering the increasing use of polymyxins to treat infections due to multidrug resistant Gram-negative in many countries, it is important to evaluate different susceptibility testing methods to this class of antibiotic. Methods Susceptibility of 109 carbapenem-resistant P. aeruginosa to polymyxins was tested comparing broth microdilution (reference method), disc diffusion, and Etest using the new interpretative breakpoints of Clinical and Laboratory Standards Institute. Results Twenty-nine percent of isolates belonged to endemic clone and thus, these strains were excluded of analysis. Among 78 strains evaluated, only one isolate was resistant to polymyxin B by the reference method (MIC: 8.0 μg/mL). Very major and major error rates of 1.2% and 11.5% were detected comparing polymyxin B disc diffusion with the broth microdilution (reference method). Agreement within 1 twofold dilution between Etest and the broth microdilution were 33% for polymyxin B and 79.5% for colisti...
A. BackgroundThe novel coronavirus disease (COVID-19) emerged in late 2019 has shown that researc... more A. BackgroundThe novel coronavirus disease (COVID-19) emerged in late 2019 has shown that research done with open data could be the cornerstone for overcoming the need for collaborative, optimized and urgent analysis. Although several articles have been published, identification of variables that can have correlation with positive PCR results is still a challenge. In this paper we show a concrete example of open data analysis from 910 patients attended in the hospital undergoing SARS-CoV-2 RT-PCR in three private institutions in S˜ao Paulo, Brazil.B. ResultsWe performed an exploratory analysis using principal component analysis, feature selection and predictive algorithms to test for associations between a number of laboratory test abnormalities and the SARS-CoV-2 RT-PCR result. More concretely, we found a set of 18 variables that showed some association with a positive PCR result.C. ConclusionAmong these variables elevated lactic dehydrogenase (LDH) and d-dimer were the most correla...
Background: Low MRSA colonization levels in a neonatal care facility are an expected occurrence. ... more Background: Low MRSA colonization levels in a neonatal care facility are an expected occurrence. Due to the rising levels of CA-MRSA, we promoted this research to evaluate the parturients as a potential source of MSSA and MRSA in the neonatal unit. Objective: Evaluate the prevalence of Staphylococcus aureus colonization in parturients at the moment of birth and determine factors associated with carriage. Methods: From March to August 2009, 148 parturients admitted to the Hospital das Clnicas of University of São Paulo were prospectively evaluated and swabs were taken from four different sites (nasal, oropharyngeal, anal and perineal). Swabs were transported in a Stuart medium to the laboratory and inoculated in agar manitol growth medium. Gram stain, catalase and DNase tests were performed to identify S. aureus which were further tested for methicillin resistance. Clinical and epidemiological data were obtained from the parturients and their neonates including: maternal underlying d...
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