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The pprevalence of extended-spectrum beta-lactamase (ESBL) producing gram-negative bacilli has increased in recent years. The aim of this study is to estimate the prevalence of infection/colonization due to theses microorganisms per 100 admissions and its trend during the period 2007-2010.Prospective observational study of all patients admitted from January 2007 to December 2010 infected or colonized with ESBL-producing gram-negative bacilli at Hospital Universitario Ramón y Cajal. The prevalence of infection/colonization of ESBL-producing gram-negative rods was calculated according to the recommendations for metrics for multidrug-resistant organisms in healthcare settings of The Society for Healthcare Epidemiology of America and the Healthcare Infection Control Practices Advisory Committee. To analyse trends, Poisson regression was used (Joinpoint Regression Program Version 3.4.3, U.S. National Institutes of Health).Through the study period there was an upward trend of prevalence of all the ESBL-producing gram-negative bacilli. The Poisson trend analysis indentified a significant inflection point in August 2009 (p=0.014).The inflection point in the prevalence of the ESBL-producing gram-negative bacilli trend can be explained by a slowdown in the prevalence of some microorganisms such as ESBL-producing Klebsiella pneumoniae.

Objetivo: Evaluar la efectividad clínica de intervenciones preventivas sistémicas o tópicas para la mucositis oral secundaria a tratamientos antineoplásicos en adultos con cáncer.Materiales y métodos: Se realizaron búsquedas en Cochrane, MEDLINE, LILACS y SCIELO. Fueron seleccionados ensayos clínicos controlados aleatorizados. Las medidas preventivas debían ser iniciadas el mismo día del inicio del tratamiento antineoplásico. Se incluyeron límites de tiempo en la búsqueda. Inicialmente se revisaron título y resumen de todos los estudios resultantes de la búsqueda y posteriormente en texto completo, la extracción de resultados se realizó por duplicado y las diferencias fueron resueltas por discusión. Se hizó un metanálisis con los estudios que fueron comparables en los programas EPIDAT y REVMAN 5.Resultados: Cuarenta y seis estudios fueron elegibles de los cuales se excluyeron 24. Se evaluaron 15 intervenciones preventivas, de ellas, nueve presentaron algún beneficio, tres intervenciones se presentaron en más de un estudio y fueron comparables para la realización de metanálisis: el amifostine, láser He/Ne y zinc. El zinc fue el único que mostró beneficio; el riesgo de desarrollar mucositis grado 2 en los pacientes que recibieron zinc fue 20% menor que en el grupo control y 73% menor para desarrollar mucositis grado 3.Conclusiones: La administración del zinc, la miel y el sucralfate han mostrado algún beneficio en la prevención o la reducción de la severidad de la mucositis asociada con el tratamiento del cáncer. La calidad y el tamaño de la muestra de estos estudios no son suficientes para recomendar estas intervenciones específicas.[Otero JA, Torres H, Pedraza AM, González AE. Prevención de la mucositis oral secundaria a tratamientos oncológicos en adultos con cáncer: revisión sistemática. Ustasalud 2011; 10: 11 - 28] Objective: To evaluate the effectiveness of interventions for the prevention of oral mucositis in cancer patients antineoplasic treated.Methods: The Cochrane Oral Health Group Trials Register, MEDLINE LILACS y SCIELO were searched. Randomized clinical trials were selected. The preventive measures must have been begun the first day of the antineoplasic treatment. Only were include the studies publish in the last 10 years. Review the title and abstract of each result of the search and extracted the outcome measures and results in duplicate. Meta-analysis was performed when two or more studies use the same intervention and was comparable. The statistical analysis was made by EPIDAT y RevMan 5.Results: Forty six studies were eligible, 24 were excluded. Fifteen interventions were evaluated, of the included interventions in this study nine showed evidence of some benefit for either preventing or reducing the severity of mucositis, three interventions were present in more than one study and comparable for performing meta-analysis: amifostine, laser He/Ne y zinc. The meta-analysis of zinc was the only one that showed beneficial effect in preventing moderate and severe mucositis.Conclusions: Especially administration of zinc, honey and sucralfate had showed some benefit at preventing or reducing the severity of mucositis associated with cancer treatment. Nevertheless the quality and the sample size of these studies are not enough for recommend and specific intervention instead of another.