RESUMO
Epidemiological surveillance provides updated information about health problems which allows for the establishment of health policy guidelines. The methods for detecting the epidemic frequency of disease require the systematic collection of data on the occurrence of specific diseases. Influenza has cyclic seasonal peaks and its endemic baseline rates are useful for identifying outbreaks: the comparison between baseline and current data supplies epidemiological evidence related to an ongoing outbreak. The upper and lower incidence curves were traced for the data referring to IA detection in the nasopharyngeal aspirates from children hospitalized for acute lower respiratory tract infection from 1996 to 2002. The arithmetic mean and the 95% confidence interval for upper and lower limits of weekly incidence were calculated. The highest incidence was observed between weeks 25 and 32. When analyzing the prepared endemic corridor, it was observed that the highest detection in 2003 occurred between weeks 19 and 25, whereas two peaks occurred in 2004, the first starting at week 20, at a lower level than the normal epidemic peak, and the second at week 26.
Assuntos
Influenza Humana/epidemiologia , Influenza Humana/virologia , Vigilância da População/métodos , Infecções Respiratórias/virologia , Estações do Ano , Argentina/epidemiologia , Criança , Pré-Escolar , Humanos , Incidência , Lactente , Recém-NascidoRESUMO
La vigilancia epidemiológica provee información actualizada y oportuna sobre los problemas de salud y sus condicionantes, lo que permite definir acciones de prevención y control. Para la detección de epidemias es útil disponer de corredores endémicos, que indican el número de casos esperados para un cuadro infeccioso en un momento determinado. Con datos de la sección Microbiología del Hospital de Niños "Dr. Pedro de Elizalde" acerca de pacientes internados con diagnóstico de infección respiratoria aguda baja (IRAB) entre el 1/1/96 y el 31/12/2002 se confeccionaron los corredores para influenza A (IA) por semanas epidemiológicas, correspondientes a un período de siete años. En ese período se internaron 10.473 niños con diagnóstico de IRAB y se identificó IA en 411 aspirados nasofaríngeos. Se calcularon la media y el intervalo de confianza de 95% para los límites superior e inferior de incidencia en períodos semanales, y se encontró que el pico estacional ocurre entre las semanas 25 y 32. Al analizar los datos del año 2003, se observó que el pico se produjo antes, entre las semanas 19 y 25, y con valores muy por encima de los esperados para esas semanas. En 2004 aparecen 2 picos, el primero en la semana 20 y sin superar los valores de fluctuación de la parte central de la curva, y el segundo en la semana 26.
Epidemiological surveillance provides updated information about health problems which allows for the establishment of health policy guidelines. The methods for detecting the epidemic frequency of disease require the systematic collection of data on the occurrence of specific diseases. Influenza has cyclic seasonal peaks and its endemic baseline rates are useful for identifying outbreaks: the comparison between baseline and current data supplies epidemiological evidence related to an ongoing outbreak. The upper and lower incidence curves were traced for the data referring to IA detection in the nasopharyngeal aspirates from children hospitalized for acute lower respiratory tract infection from 1996 to 2002. The arithmetic mean and the 95% confidence interval for upper and lower limits of weekly incidence were calculated. The highest incidence was observed between weeks 25 and 32. When analyzing the prepared endemic corridor, it was observed that the highest detection in 2003 occurred between weeks 19 and 25, whereas two peaks occurred in 2004 , the first starting at week 20, at a lower level than the normal epidemic peak, and the second at week 26.
Assuntos
Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Influenza Humana/epidemiologia , Influenza Humana/virologia , Vigilância da População/métodos , Infecções Respiratórias/virologia , Estações do Ano , Argentina/epidemiologia , IncidênciaRESUMO
Candida spp. colonization in neonates occurs due to vertical or horizontal transmission. Preliminary studies determined that Candida albicans is the principal agent of these infections. In order to establish nosocomial transmission, 26 Candida albicans strains isolated from patients with candidosis hospitalized during a 18-month period in 2 neonatal intensive care units (NICU) from a pediatric hospital were studied. Fourteen isolates from patients and health care workers, involved in possible outbreaks of an intensive care unit (UCI) and a NICU from another pediatric hospital were also studied. All Candida albicans strains were genotyped by Southern blot hybridization with 27A. Isolates for outbreak confirmation were also hybridized with another specific Candida albicans probe, Ca3. Hybridization patterns demonstrated horizontal transmission in all the units studied. In a NICU, transmission among 4 patients during a 10-month period could be established and in the other NICU, 3 cases of transmission among 2 patients each were demonstrated in periods of 2 to 20 days. The outbreak studies showed the same strain isolated from 2 nurses and from one patient at the NICU and at the ICU identical strains were found in 3 patients. In this study, hybridization with Ca3 in addition to 27A probe did not increase discrimination power among isolates. Genotypic analysis allows, not only, determination of transmission and persistence of strains during prolonged periods or in sporadic outbreaks, but also facilitates necessary epidemiological decisions for optimizing nosocomial fungal infection control measures.(AU)
Assuntos
Humanos , Recém-Nascido , RESEARCH SUPPORT, NON-U.S. GOVT , Candidíase/transmissão , Infecção Hospitalar/transmissão , Transmissão de Doença Infecciosa , Candida albicans/isolamento & purificação , Candidíase/microbiologia , Infecção Hospitalar/microbiologia , Unidades de Terapia Intensiva NeonatalRESUMO
Candida spp. colonization in neonates occurs due to vertical or horizontal transmission. Preliminary studies determined that Candida albicans is the principal agent of these infections. In order to establish nosocomial transmission, 26 Candida albicans strains isolated from patients with candidosis hospitalized during a 18-month period in 2 neonatal intensive care units (NICU) from a pediatric hospital were studied. Fourteen isolates from patients and health care workers, involved in possible outbreaks of an intensive care unit (UCI) and a NICU from another pediatric hospital were also studied. All Candida albicans strains were genotyped by Southern blot hybridization with 27A. Isolates for outbreak confirmation were also hybridized with another specific Candida albicans probe, Ca3. Hybridization patterns demonstrated horizontal transmission in all the units studied. In a NICU, transmission among 4 patients during a 10-month period could be established and in the other NICU, 3 cases of transmission among 2 patients each were demonstrated in periods of 2 to 20 days. The outbreak studies showed the same strain isolated from 2 nurses and from one patient at the NICU and at the ICU identical strains were found in 3 patients. In this study, hybridization with Ca3 in addition to 27A probe did not increase discrimination power among isolates. Genotypic analysis allows, not only, determination of transmission and persistence of strains during prolonged periods or in sporadic outbreaks, but also facilitates necessary epidemiological decisions for optimizing nosocomial fungal infection control measures.
Assuntos
Humanos , Recém-Nascido , Candidíase/transmissão , Infecção Hospitalar/transmissão , Transmissão de Doença Infecciosa , Candida albicans , Candidíase/microbiologia , Infecção Hospitalar/microbiologia , Unidades de Terapia Intensiva NeonatalRESUMO
Candida spp. colonization in neonates occurs due to vertical or horizontal transmission. Preliminary studies determined that Candida albicans is the principal agent of these infections. In order to establish nosocomial transmission, 26 Candida albicans strains isolated from patients with candidosis hospitalized during a 18-month period in 2 neonatal intensive care units (NICU) from a pediatric hospital were studied. Fourteen isolates from patients and health care workers, involved in possible outbreaks of an intensive care unit (UCI) and a NICU from another pediatric hospital were also studied. All Candida albicans strains were genotyped by Southern blot hybridization with 27A. Isolates for outbreak confirmation were also hybridized with another specific Candida albicans probe, Ca3. Hybridization patterns demonstrated horizontal transmission in all the units studied. In a NICU, transmission among 4 patients during a 10-month period could be established and in the other NICU, 3 cases of transmission among 2 patients each were demonstrated in periods of 2 to 20 days. The outbreak studies showed the same strain isolated from 2 nurses and from one patient at the NICU and at the ICU identical strains were found in 3 patients. In this study, hybridization with Ca3 in addition to 27A probe did not increase discrimination power among isolates. Genotypic analysis allows, not only, determination of transmission and persistence of strains during prolonged periods or in sporadic outbreaks, but also facilitates necessary epidemiological decisions for optimizing nosocomial fungal infection control measures.
Assuntos
Candidíase/transmissão , Infecção Hospitalar/transmissão , Transmissão de Doença Infecciosa , Candida albicans/isolamento & purificação , Candidíase/microbiologia , Infecção Hospitalar/microbiologia , Humanos , Recém-Nascido , Unidades de Terapia Intensiva NeonatalRESUMO
Candida spp. colonization in neonates occurs due to vertical or horizontal transmission. Preliminary studies determined that Candida albicans is the principal agent of these infections. In order to establish nosocomial transmission, 26 Candida albicans strains isolated from patients with candidosis hospitalized during a 18-month period in 2 neonatal intensive care units (NICU) from a pediatric hospital were studied. Fourteen isolates from patients and health care workers, involved in possible outbreaks of an intensive care unit (UCI) and a NICU from another pediatric hospital were also studied. All Candida albicans strains were genotyped by Southern blot hybridization with 27A. Isolates for outbreak confirmation were also hybridized with another specific Candida albicans probe, Ca3. Hybridization patterns demonstrated horizontal transmission in all the units studied. In a NICU, transmission among 4 patients during a 10-month period could be established and in the other NICU, 3 cases of transmission among 2 patients each were demonstrated in periods of 2 to 20 days. The outbreak studies showed the same strain isolated from 2 nurses and from one patient at the NICU and at the ICU identical strains were found in 3 patients. In this study, hybridization with Ca3 in addition to 27A probe did not increase discrimination power among isolates. Genotypic analysis allows, not only, determination of transmission and persistence of strains during prolonged periods or in sporadic outbreaks, but also facilitates necessary epidemiological decisions for optimizing nosocomial fungal infection control measures.
RESUMO
Few reports of vancomycin-resistant enterococci have appeared outside the USA. Therefore, we evaluated the ability of five laboratories in Buenos Aires, Argentina, to perform susceptibility testing using the disk diffusion method. Laboratories had difficulty identifying the low- and intermediate-level vancomycin-resistant phenotypes. This suggests that the disk diffusion method used by laboratories abroad may fail to detect some vancomycin-resistant enterococci.
Assuntos
Antibacterianos/farmacologia , Enterococcus/efeitos dos fármacos , Enterococcus/isolamento & purificação , Laboratórios/normas , Testes de Sensibilidade Microbiana/métodos , Vancomicina/farmacologia , Argentina , Técnicas Bacteriológicas/normas , Meios de Cultura , Resistência Microbiana a Medicamentos , Humanos , Sensibilidade e EspecificidadeRESUMO
BACKGROUND: One of the principal causes of bacterial meningitis (BM) in children older than one month is Neisseria meningitidis (Nm). A quick diagnosis and an immediate treatment are considered essential for a good outcome. We propose this study with the purpose of evaluating the clinical and epidemiological characteristics of the patients with BM caused by Nm and analyzing the effect on the presentation and incidence of sequelae and/or complications of the time elapsed since the starting of symptoms and the beginning of the treatment. METHODS: We performed a retrospective analysis of the clinical registers of 76 patients diagnosed as BM caused by Nm entered in the Hospital de Pediatria Pedro de Elizalde, Buenos Aires, Argentina, during the years 1992 and 1993. We investigated age, sex, date of entrance, first symptoms, biochemistry of cerebrospinal fluid (CSF), nutritional status, convulsions and/or complications, length of internation and conditions at discharge. Processing was done with Epi-info 5.0. Differences between qualitative variables were analyzed with chi 2 and differences between means with z-test. RESULTS: Boys were majority; fever was the most frequent initial symptom; petechiae were less frequently found, specially among infants. 79% of the patients had CSF of purulent characteristics; 32.9% of the patients had complications during their evolution; its incidence raised up to 48% in infants. Lethality was 1.3%, 6.5% of the children had sequelae at the moment of discharge. The average time of internment was 13 days. There were no significant differences when different groups were compared according to their prior evolution time. CONCLUSIONS: 1) Petechiae and vomits were significantly less frequent in infants; 2) the incidence of complications was significantly higher in this last group; 3) no greater incidence of complications or sequelae was observed in patients whose previous period of evolution was longer than 48 hours; 4) in all groups of age we found insidious forms of starting, and 5) there were patients with CSF of normal biochemical characteristics in all groups considered independently of the time of evolution elapsed.
Assuntos
Meningite Meningocócica/epidemiologia , Argentina/epidemiologia , Dano Encefálico Crônico/epidemiologia , Dano Encefálico Crônico/etiologia , Líquido Cefalorraquidiano/citologia , Proteínas do Líquido Cefalorraquidiano/análise , Criança , Pré-Escolar , Comorbidade , Feminino , Febre/etiologia , Hospitais Pediátricos , Humanos , Incidência , Lactente , Contagem de Leucócitos , Masculino , Meningite Meningocócica/líquido cefalorraquidiano , Meningite Meningocócica/complicações , Meningite Meningocócica/diagnóstico , Distúrbios Nutricionais/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Convulsões/etiologiaRESUMO
OBJECTIVE: To determine the incidence of nosocomial diarrhea as a quality assessment tool, to compare such a rate with a standard rate based on results reported in the literature, and to estimate the hospital cost of narrowing the gap between both. METHODS: This was a prospective hospital-based surveillance study of patients in a 16-cradle ward of a 316-bed public-owned children's hospital in Buenos Aires, Argentina. One hundred six pediatric patients were enrolled during the 3-month surveillance period. Data were collected by a non-attending physician under the usual conditions of care. The clinical staff members were blinded to the objectives of the investigation. RESULTS: The detected incidence rate was 22.6 episodes of nosocomial diarrhea per 100 admissions. This was 6.4-fold higher than the standard rate. Each day of nosocomial diarrhea lengthened the duration of hospitalization and thereby increased the total hospital bill of each patient. The potential savings from narrowing the gap between both rates was as much as $302,400 per year. CONCLUSIONS: Nosocomial diarrhea stands out as a relevant target both for quality improvement opportunity assessment and for cost-containment-oriented efforts.