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Infecção hospitalar ou nosocomial é aquela adquirida durante a hospitalização do paciente, e que pode ser relacionada os procedimentos hospitalares invasivos realizados durante o internamento. O presente trabalho teve como objetivos estudar a ocorrência de infecção hospitalar em animais atendidos em um Centro Cirúrgico Veterinário Universitário de Pequenos Animais submetidos a procedimentos cirúrgicos e/ou invasivos; discutir as possíveis causas de infecção, detectar as bactérias presentes quando possível e verificar a sensibilidade antimicrobiana destes agentes. O trabalho foi desenvolvido através do acompanhamento diário de 131 animais internados neste setor e busca ativa de casos de infecção hospitalar. Em 104 animais (91 cães e 13 felinos), foram realizados 113 procedimentos cirúrgicos e em 27 animais condutas não cirúrgicas tais como acompanhamento de parto e pós-parto, desobstrução uretral e colocação de talas. Todos os animais foram submetidos à colocação de cateter para fluidoterapia e/ou aplicação de medicamentos e/ou anestésicos em algum momento durante o internamento. O índice de infecção do sítio cirúrgico foi de 7,96% sendo 4,54% nas cirurgias limpas, 4,25% nas cirurgias limpa-contaminadas, 10,53% nas cirurgias contaminadas e 16% nas cirurgias infectadas. A taxa de infecção hospitalar não cirúrgica no paciente cirúrgico foi de 2,88% e 3,7% no paciente não cirúrgico. Foram cultivados sete isolados bacterianos, sendo Pseudomonas sp. (3), Streptococcus sp. (2), Acinetobacter sp. (1) e bacilo Gram negativo (1), constatando-se multirresistência bacteriana alta em todos os isolados. A duração da cirurgia e os tempos de internamento pré e pós-operatório não influenciaram na ocorrência de infecção hospitalar, mas os fatores que provavelmente colaboraram para a ocorrência de infecções no presente trabalho foram a própria gravidade da doença que motivou o tratamento, o tipo de procedimento realizado e a gravidade das lesões concomitantes.

Hospital or nosocomial infections are infections acquired during patient hospitalization, and that can be related to surgical and invasive procedures performed during the hospital admission. The present study aimed to investigate the occurrence of nosocomial infection in animals treated at a Veterinary Surgical Center of Small Animals, submitted to surgical or invasive procedures, to discuss the possible causes of infection, to detect the bacteria present when possible, and to verify the antimicrobial sensitivity of these agents. The study was developed through daily monitoring of 131 animals admitted in this surgical center and doing active surveillance of cases of nosocomial infection. In 104 animals (91 dogs and 13 cats), 113 surgical procedures were performed, and in 27 animals were performed non-surgical procedures such monitoring of delivery and postpartum, urethral catheterization and placement of splints. All animals were submitted to catheter placement for fluid therapy and application of medications and/or anesthetic at some point during hospitalization. The rate of surgical site infection was 7.96%, and by categories was 4.54% in clean surgeries, 4.25% in clean-contaminated surgeries, 10.53% in contaminated surgeries, and 16% in infected surgeries. The rate of non-surgical nosocomial infection in surgical patients was 2.88% and in the non-surgical patient was 3.7%. Bacteria were cultured as follows: Pseudomonas sp. (3), Streptococcus sp. (2), Acinetobacter sp. (1) and Gram negative bacilli (1), and high bacterial multidrug resistance were observed in all isolates. The duration of surgery and pre and postoperative time of hospitalization did not affect the occurrence of nosocomial infection, but factors that probably contributed to the occurrence of infections in this study were the severity of the condition responsible for the treatment, the kind of procedure performed and the severity of lesions.

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Objetivos: El seguimiento de pacientes de lepra muy bacilíferos durante un largo período después del alta de su tratamiento (RFT) y la detección de posibles recidivas. Resultados: Se siguió a 600 pacientes con un índice bacteriológico de positividad 4+, 5+ o 6+ y que habían completado la multiterapia OMS y dados de alta. Se controló la regularidad de su tratamiento mediante visitas domiciliarias. Después de la RFT fueron revisados dos veces, una entre los 4-9 años y otra a los 7-12 años. Se examinaron 516 pacientes en la segunda revisión. Por criterios de la OMS, 5 pacientes habían recidivado, con un índice de recidivas del 0.103 por 100 personas/año. Esta baja recidiva podría atribuirse a la elevada adherencia al tratamiento. Conclusión: Se puede conseguir mediante un MDT supervisado y buena adherencia al tratamiento un bajo índice de recidivas (AU)

Objective. To follow up highly bacillated leprosy patients for a long period after release from treatment (RFT) and to look out for possibility of relapses. Results. 660 patients with an initial bacterial positivity of 4 +, 5 + or 6 + who had undergone WHO multi-drug therapy and released from treatment, were followed up. The regularity of their treatment was kept high by close monitoring with home visits. They were reviewed twice, once 4 to 9 years after RFT and again 7 to 12 years after RFT. 516 patients were available in the second review. As per WHO definition, 5 patients were found to have relapsed, giving a relapse rate of 0.103 per 100 person years. This low relapse rate could be due to high regularity of treatment. Conclusion. With well supervised MDT and high regularity of treatment and proper consumption of drugs, relapse rate is very low (AU)

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In 1991, we reported that 55% of laboratories participating in the Wisconsin Proficiency Testing Program could not accurately identify serum samples from Lyme disease patients containing antibody against Borrelia burgdorferi. The purpose of this study was to determine whether the accuracy of Lyme disease test results reported by approximately 500 participants in the Wisconsin State Laboratory of Hygiene/College of American Pathologists Lyme Disease Survey had improved. From 1992 through 1994, 50 serum samples were sent to participants of the survey. Each laboratory received 28 serum samples from individuals with Lyme disease according to the case definition of the Centers for Disease Control and Prevention and 22 serum samples from healthy individuals. Unfortunately, the serodiagnosis of Lyme disease by participants had not improved. The specificity of the Lyme disease assays steadily decreased from approximately 95% to approximately 81% during the 3-year period of the survey. False-positive test results approached 55% with some of the serum samples from healthy donors. A serum sample containing antibody against Treponema pallidum was reported as positive by 70% of the participants. In addition, the sensitivity fluctuated between 93 and 75%, depending upon the conjugate used by the laboratories. These results suggest that stronger criteria must be applied for approving and continuing to approve commercially available kits for the serodiagnosis of Lyme disease.

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The Signal blood culture system was compared with the Bactec NR-660. A total of 1617 blood culture sets yielded 143 (8.8%) significant isolates; 113 (79.0%) were from positive bottles in both the Bactec and Signal systems. Twelve organisms (8.4%) were detected and isolated from the Signal system only and another 18 (12.6%) from the Bactec system only. Of these 18, five were Signal-positive but the organism was not recovered and four organisms were isolated from negative Signal bottles on terminal subculture. The time taken to detection for each system was similar; the Signal system detected 68% and the Bactec 63% of significant positives within 24 h. At 48 h Bactec detected 91% and the Signal 85%. A significantly-reduced number of bottles which gave a positive signal but were negative by microscopical and cultural methods was found, compared with previous reports. The 1 h incubation period prior to the insertion of the Signal growth indicator device was considered to be the cause of this reduction in the proportion of false positives. Fifty-five percent (42/77) of the Bactec false positives were due to delta growth value. This is when there is an increase in the growth index of > or = 15 without the positive threshold level of 30 being attained. This occurred in the anaerobic bottle on day 2 with 42 bottles. Another 40% (31/77) of the false positives had a growth value between the positive threshold of 30 and a value of 35. Eighty (4.9%) of Bactec and 65 (4.0%) of Signal sets yielded clinically non-significant isolates.(ABSTRACT TRUNCATED AT 250 WORDS)

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Between July 28th and December 28th, 1991, 2,935 cases of diarrhoeal illness were reported to the National Surveillance Unit of the Ministry of Health, in response to the intensified surveillance activities of the Cholera Preparedness Programme. The cases notified included 1,656 children less than five years of age (56.4 percent) and 1,279 persons over age five. The average number of reported cases per week was 133 with a range of 62-202 cases. A review of certain laboratory indicators was recently undertaken in order to assess the ease with which cholera would spread locally if introduced into Trinidad and Tobago. This analysis is based on data produced by the Trinidad Public Health Laboratory (AU)

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