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Introduction. Carbapenem-resistant Pseudomonas aeruginosa is responsible for increased patient mortality. Gap Statement. Five and 30 day in-hospital all-cause mortality in patients with P. aeruginosa infections were assessed, followed by evaluations concerning potential correlations between the type III secretion system (TTSS) genotype and the production of metallo-β-lactamase (MBL). Methodology. This assessment comprised a retrospective cohort study including consecutive patients with carbapenem-resistant infections hospitalized in Brazil from January 2009 to June 2019. PCR analyses were performed to determine the presence of TTSS-encoding genes and MBL genes. Results. The 30-day and 5-day mortality rates for 262 patients were 36.6 and 17.9 %, respectively. The unadjusted survival probabilities for up to 5 days were 70.55 % for patients presenting exoU-positive isolates and 86 % for those presenting exo-negative isolates. The use of urinary catheters, as well as the presence of comorbidity conditions, secondary bacteremia related to the respiratory tract, were independently associated with death at 5 and 30 days. The exoS gene was detected in 64.8 % of the isolates, the presence of the exoT and exoY genes varied and exoU genes occurred in 19.3 % of the isolates. The exoU genotype was significantly more frequent among multiresistant strains. MBL genes were not detected in 92 % of the isolates. Conclusions. Inappropriate therapy is a crucial factor regarding the worse prognosis among patients with infections caused by multiresistant P. aeruginosa , especially those who died within 5 days of diagnosis, regardless of the genotype associated with TTSS virulence.

Objective: To establish a baseline of knowledge regarding about inappropriate therapy, virulence and resistance in a cohort of patients infected with S. aureus. Methods: Retrospective cohort study in tertiary-care university hospital was employed to evaluate the risk factors and the impact of inappropriate therapy among patients with Staphylococcus aureus infections, resistance and virulence. To assess the presence of the genes was performed PCR. Results: Patients with MRSA were older and hospitalized 17 days longer than those with MSSA infection, which were in ICU with a bloodstream infection. 50.0% received inadequate antibiotic therapy and we found virulence factors associated with MRSA (mecA, LukS, fnbB and clfA genes). Conclusion: These data show that surveillance studies related to Staphylococcus aureus infections remain essential to identify resistance and inform policy on resistance.

Introdução: A pneumonia associada í ventilação mecânica (PAV) é uma infecção pulmonar que se desenvolve em uma pessoa que está sob uso do ventilador. A incidência em hospitais brasileiros pode variar de 23,2% a 50% nas Unidades de Terapia Intensiva. Objetivo: Reunir, sintetizar e integrar resultados de estudos primários que investigaram a importância da adoção de cuidados de enfermagem. Material e métodos: Utilizou-se a revisão integrativa e a pesquisa foi realizada em bases de dados eletrônicas na área da saúde. Os descritores utilizados foram: "Pneumonia associada í ventilação mecânica", "Higiene oral" e "Enfermagem". Foram incluí­dos 8 estudos na amostra. Resultados: Os profissionais de enfermagem reconhecem a importância das medidas de prevenção contra a PAV, apesar de não ter muita adesão. Esses cuidados apresentam impacto positivo quando são realizados. Dentre as principais está a higiene oral. Conclusão: A PAV tem uma elevada frequência nas Unidades de Terapia Intensiva em diversos hospitais do paí­s. Para que essa ocorrência diminua é necessária í adoção de medidas preventivas que estejam incluí­das na rotina dos cuidados de enfermagem, dentre os procedimentos, a higiene oral é a que mais se destaca.Palavras-chave: pneumonia associada í ventilação mecânica, higiene bucal, Enfermagem.

Objective: This study aimed to evaluate the quality of life, through the “Medical Outcomes Study 36 - Item Short - Form Health Survey” (SF-36) questionnaire, of a group of elderly involved in physical activities scheduled and the impact of physical activity time. Methods: We assessed 143 elderly engaged in physical activity programmed by Universidade Federal de Uberlândia. As a data collection tool, we used the SF-36 and a sociodemographic questionnaire, applied at the time of the interview. Statistical analysis was performed using Kruskal-Wallis, for analysis between domains, and Mann-Whitney test, to verify the relationship between health status and physical activity level. Results: The average age was 70.5 years. The mean score for the SF-36 of the elderly people who participated in the research was 73.3. The best result was in the Social Aspects domain (81.7), followed by Mental Health (78.9). Approximately 76% had at least 150 minutes of physical activity per week, being classified as a more active population. Most (70.6%) of the elderly had a good perception of their general health. There was statistical difference in the General Health domain among groups that performed physical activity for a period of less than one year and those who have been engaging in regular physical activity for over 10 years. Conclusions: The Social Function and Mental Health domains had the highest scores, with significant documentation of a better general health in the group that have practiced consecutive physical activity for over ten years.

INTRODUCTION: This study aimed to determine the epidemiology of the three most common nosocomial infections (NI), namely, sepsis, pneumonia, and urinary tract infection (UTI), in a pediatric intensive care unit (PICU) in a developing country and to define the risk factors associated with NI. METHODS: We performed a prospective study on the incidence of NI in a single PICU, between August 2009 and August 2010. Active surveillance by National Healthcare Safety Network (NHSN) was conducted in the unit and children with NI (cases) were compared with a group (matched controls) in a case-control fashion. RESULTS: We analyzed 172 patients; 22.1% had NI, 71.1% of whom acquired it in the unit. The incidence densities of sepsis, pneumonia, and UTI per 1,000 patients/day were 17.9, 11.4, and 4.3, respectively. The most common agents in sepsis were Enterococcus faecalis and Escherichia coli (18% each); Staphylococcus epidermidis was isolated in 13% of cases. In pneumonias Staphylococcus aureus was the most common cause (3.2%), and in UTI the most frequent agents were yeasts (33.3%). The presence of NI was associated with a long period of hospitalization, use of invasive devices (central venous catheter, nasogastric tube), and use of antibiotics. The last two were independent factors for NI. CONCLUSIONS: The incidence of NI acquired in this unit was high and was associated with extrinsic factors. INTRODUÇÃO: O objetivo deste estudo foi determinar a epidemiologia das três infecções hospitalares (IH) mais comuns - sepse, pneumonia e infecção do trato urinário (ITU) - em uma unidade de terapia intensiva pediátrica (UTIP) de um país em desenvolvimento e definir os fatores de risco associados com IH. MÉTODOS:Nós desenvolvemos um estudo prospectivo de incidência de IH em uma única UTIP, entre agosto/2009 e agosto/2010. Foi conduzida uma vigilância ativa pelo National Healthcare Safety Network (NHSN) na Unidade e as crianças com IH (casos) foram comparadas com um grupo (controles) em um estudo caso-controle. RESULTADOS: Nós analisamos 172 pacientes, 22,1% com IH, 71,1% adquirida na Unidade. A densidade de incidência de sepse, pneumonia e ITU por 1.000 pacientes/dia foram 17,9, 11,4, e 4,3, respectivamente. Os agentes mais comuns na sepse foram Enterococcus faecalis e Escherichia coli (18% cada), e Staphylococcus epidermidis foram isolados em 13% dos casos. Nas pneumonias Staphylococcus aureus foram os agentes mais comuns (3,2%), e nas ITUs os agentes mais frequentes foram os fungos (33,3%). A presença de IH foi associada com tempo de hospitalização prolongado, uso de procedimentos invasivos (CVC, sonda nasogástrica) e uso de antibióticos. Os dois últimos foram fatores independentes para o desenvolvimento de IH. CONCLUSÕES: A incidência de IH adquirida na Unidade foi alta, associada a fatores de risco extrínsecos.