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Introdução: A produção de NDM-1 é cada vez mais comum nesta nova geração de bactérias multirresistentes. Objetivo e Métodos: Este estudo avalia a ocorrência de metalo-β-lactamase, especialmente NDM em Pseudomonas aeruginosa no estado de Minas Gerais, Brasil, por meio de um teste do disco combinado para triagem de isolados e Reação em Cadeia de Polimerase para pesquisar os genes para metalo-β-lactamases. Resultados: Das 95 cepas analisadas, todas resistentes aos carbapenêmicos, 20% eram fenotipicamente positivas para metalo-β-lactamases, e 1% positivas para o gene blaSPM e 2,1% para blaNDM. Conclusões: No Brasil, as carbapenemases SPM sempre foram predominantes entre os isolados clínicos de P. aeruginosa, mas não a NDM. Este estudo destaca a necessidade de revisão de protocolos clínicos, a fim de conter a disseminação desse novo perfil.

Rheumatic fever (RF) and rheumatic heart disease (RHD) are still highly prevalent, particularly in low- and middle-income countries. RHD is a neglected and underdiagnosed disease for which no specific laboratory diagnostic test is completely reliable. This is a retrospective observational study, which included 118 patients with RHD who underwent cardiac surgery from 1985 to 2018. The aim of this investigation was to evaluate the clinical, epidemiological, echocardiographic and pathological characteristics in two cohorts of RHD patients: one cohort with Aschoff bodies present in their pathological results and the other without such histopathological characteristics. No conventional clinical and laboratory tests for RHD myocarditis were able to identify active carditis during the preoperative phase of valve repair or replacement. Patients who had Aschoff bodies in their pathological results were younger (median age of 13 years (11–24 years) vs. 27 years (17–37 years), p = 0.001) and had higher rate of late mortality (22.9% vs. 5.4%, p = 0.043). In conclusion, the presence of Aschoff bodies in pathological findings may predict increased long-term mortality, emphasizing the importance of comprehensive pathology analysis for suspected myocarditis during heart surgery.

Background and objectives: Bloodstream infection (BSI) by multidrug-resistant Pseudomonas aeruginosa is a severe infection. This study aimed to evaluate and identify the predictors of mortality in patients who had bloodstream infection by carbapenem-resistant P. aeruginosa. Methods: This is a retrospective cohort study, approved by Committee of Ethics in Research with Human Participants, which included 87 consecutive patients hospitalized in a referral hospital in Brazil. Clinical and demographic information about each patient were obtained from hospital records. The Student’s T-test was used to compare continuous variables and x2 or Fisher’s exact tests to compare categorical variables. To determine independent risk factors for 30-day mortality, a multiple logistic regression model was used. A survival curve was constructed using the Kaplan–Meier method. Results: Among the patients, 87.3% use antibiotics previously, 60.9% received inadequate empirical treatment, and the 30-day mortality rate was 57.5%. Inappropriate antibiotic empirical therapy was independently associated with a 30-days death and mortality rate. Conclusion: These findings can show some insights about the relationship between higher mortality and inappropriate empirical therapy for patients with BSI by P. aeruginosa. There is a need for better diagnostic tests and infection control programs should focus on de-escalation the antibiotic inappropriate therapy, mainly in BSI caused by carbapenem-resistant P. aeruginosa.

La separación entre información y opinión es uno de los principios deontológicos clásicos del periodismo. Su objetivo es evitar la desinformación, permitiendo a los destinatarios distinguir con claridad entre la información factual —respecto de la que existe una expectativa de veracidad— y las tomas de posición políticas, morales, etc. del periodista. Pero ¿cabe convertir ese principio en un deber jurídico? ¿Puede un Estado exigir responsabilidad a los periodistas o a los medios por su incumplimiento? En su Sentencia de 28.4.2020 (caso ATV Zrt c. Hungría, demanda n.º 61178/14), el Tribunal Europeo de Derechos Humanos debió afrontar esta delicada cues-tión. Aunque la sentencia desaprovechó en cierta medida la ocasión para tomar posición clara al respecto, un voto particular fijó de un modo más conciso el campo del debate y las vías para su tratamiento. El hecho de que el Estado dicte cómo deben comunicarse las noticias, incluso con las mejores intenciones, genera un elevadísimo riesgo para las libertades comunicativas. Por ello, el voto particular apunta a la necesidad de acudir a instrumentos autorregulatorios y corregulatorios, y no a reglas de derecho imperativo.

Introdução/Objetivo: Com o passar dos anos, tornou-se alarmante o uso excessivo e inapropriado de antimicrobianos no ambiente hospitalar, particularmente em países de baixa e média renda como o Brasil. O estudo teve como objetivos investigar as práticas de prescrição de antimicrobianos em pacientes hospitalizados em 58 Unidades de Terapia Intensiva (UTIs) de adultos brasileiras, de hospitais terciários e não terciários. Métodos: Foi realizado estudo multicêntrico através de inquéritos de prevalência pontual em 58 UTIs localizadas nas cinco regiões do Brasil: 6 UTIs no Norte, 10 no Nordeste, 2 no Centro-Oeste, 39 no Sudeste e 1 no Sul. Os hospitais coparticipantes foram selecionados de forma aleatória. As instituições foram organizadas de acordo com o tipo (hospital universitário ou não universitário) e porte (< 200 leitos, 200-400 leitos, > 400 leitos). Foram consideradas todas as prescrições de antimicrobianos administradas em pacientes internados no dia da coleta de dados e sua finalidade (terapêutica ou profilática). Resultados: Foram incluídos 664 pacientes no estudo, dos quais 70,3% faziam uso de pelo menos um antimicrobiano, 46,0% recebiam tratamento direcionado para IRAS e apenas 38,5% dos casos baseavam-se em critérios microbiológicos. A prevalência de IRAS variou entre 32,1% e 83,3% e o uso de antibióticos entre 53,1% e 83,3%. Hospitais de ensino com > 400 leitos e aqueles com tamanho de 201-400 leitos tiveram as taxas mais altas de uso de antibióticos com 75,0% e 70,2%, respectivamente, já o tratamento empírico foi mais frequente em hospitais com < 200 leitos (75,6%) e que não eram de ensino (72,6%). Em geral, o tratamento foi mais comumente direcionado para pneumonia (47,5%) e infecções da corrente sanguínea (33,1%). Glicopeptídeos (43,1%) e Polimixinas (39,0%) foram mais frequentes em Hospitais Universitários, β-Lactâmicos em combinação com um inibidor (75,2%), cefalosporinas de amplo espectro (70,0%) e carbapenêmicos (68,1%) em Hospitais não Universitários. Conclusão: Nosso estudo fornece dados alarmantes sobre o consumo de antibióticos em UTIs de adultos brasileiras, onde infelizmente grande parte dos pacientes são submetidos a tratamento empírico e com isso possivelmente sua adequação deve ser rara devido à ausência de critérios microbiológicos. Esses resultados devem encorajar uma reavaliação do uso de antimicrobianos nos hospitais do país. Apoio: FAPEMIG/PPSUS, CNPq, CAPES.

Rheumatic heart disease (RHD) remains to be a very important health issue worldwide, mainly in underdeveloped countries. It continues to be a leading cause of morbidity and mortality throughout developing countries. RHD is a delayed non-suppurative immunologically mediated inflammatory response to the throat infection caused by a hemolytic streptococcus from the A group (Streptococcus pyogenes). RHD keeps position 1 as the most common cardiovascular disease in young people aged

Locating the position of a remote node on a wireless network is becoming more relevant, as we move forward in the Internet of things and in autonomous vehicles. This paper proposes a new system to implement the location of remote nodes. A new prototype Android application has been developed to collect real measurements and to study the performance of several smartphone's sensors and location algorithms, including an innovative one, based on the second order cone programming (SOCP) relaxation. The application collects the WiFi access points information and the terminal location. An internal odometry module developed for the prototype is used when Android's service is unavailable. This paper compares the performance of existing location estimators given in closed form, an existing SOCP one, and the new SOCP location estimator proposed, which has reduced complexity. An algorithm to merge measurements from non-identical terminals is also proposed. Cooperative and terminal stand-alone operations are compared, showing a higher performance for SOCP-based ones, that are capable of estimating the path loss exponent and the transmission power. The heterogeneous terminals were also used in the tests. Our results show that the accurate positioning of static remote entities can be achieved using a single smartphone. On the other hand, the accurate real-time positioning of the mobile terminal is provided when three or more scattered terminal nodes cooperate sharing the samples taken synchronously.

Abstract Background Avian pathogenic Escherichia coli (APEC) isolated from avian cellulitis lesions produces a toxin, named Escherichia coli vacuolating factor (ECVF), that causes cell vacuolization and induces inflammatory response in broiler chicken. Methods We investigated the intracellular activities of ECVF in avian fibroblasts using fluorescence staining, electron microscopy, MTT and LDH measurements. As ECVF act specifically in avian cells, we performed blotting assay followed by mass spectrometry to better understand its initial intracellular protein recognition. Results ECVF induced actin contraction, mitochondrial damage and membrane permeability alterations. Ultrastructural analysis showed intracellular alterations, as nuclear lobulation and the presence of degraded structures inside the vacuoles. Moreover, ECVF induced cell death in fibroblasts. ECVF-biotin associates to at least two proteins only in avian cell lysates: alpha-actinin 4 and vinculin, both involved in cytoskeleton structure. Conclusion These findings demonstrated that ECVF plays an important role in avian cellulitis, markedly in initial steps of infection. Taken together, the results place this toxin as a target for drug and/or vaccine development, instead of the use of large amounts antibiotics.

Abstract INTRODUCTION: The present study aimed to determine the incidence of health care-associated infections (HCAIs) and identify the main resistant microorganisms in intensive care unit (ICU) patients in a Brazilian university hospital. METHODS: A retrospective cohort study was conducted in a Brazilian teaching hospital between 2012 and 2014. RESULTS: Overall, 81.2% of the infections were acquired in the ICU. The most common resistant pathogenic phenotypes in all-site and bloodstream infections were oxacillin-resistant coagulase-negative staphylococci and carbapenem-resistant Acinetobacter spp. (89.9% and 87.4%; 80.6% and 70.0%), respectively. CONCLUSIONS: There is an urgent need to focus on HCAIs in ICUs in Brazil.

The influence of a mesoscale convective system (MCS) in the evolution of two wildfires that started during the afternoon of 17 June 2017 in Pedrógão Grande, Central Portugal is discussed and analysed using weather radar data, weather stations, video images and fire spread analysis. As the MCS approached the region, its convectively driven flows started to influence the fires. The overturning flows were formed by two main limbs: one organised as front-to-rear deep layer inflows that propagated over the convective region of the MCS and the other as rear-to-front mid-level inflows that descended below the anvil structure of the MCS. The rear-to-front inflows, while accelerating and descending to lower levels, contributed to modify the fires’ intensity and plume characteristics. After the two fires merged, the resulting junction fire became very intense and impossible to control. Then, a firestorm was generated, causing the deaths of 66 people. The main goal of this study is to detail the influence of the MCS in the fire spread, thus contributing to the general knowledge of outstanding fire behaviour modifications due to the influence of atmospheric convective processes.

A utilização das novas tecnologias móveis tornou-se um fenómeno global. Existe “uma cultura jovem móvel global” e uma “emergência da sociabilidade em rede” (Castells et al., 2009: 183-184). O objetivo deste estudo passou por compreender a utilização dos telemóveis pelos millennials, que gratificações procuram e os efeitos sociais gerados pela utilização destes equipamentos. O trabalho desenvolvido, através de uma metodologia mista que reuniu a investigação quantitativa e qualitativa, compreendeu a análise de 649 questionários a jovens adultos e 46 posts das páginas da rede social Facebook, dos principais operadores do setor das telecomunicações, em Portugal. O efeito da vivência da experiência de fluxo, entre outros resultados revelados pelo modelo de equações estruturais, poderá servir de advertência para os próprios utilizadores, pais, empresas e escolas que funcionam como mediadores do ensino da linguagem, através das novas tecnologias.

Plesiomonas shigelloides isolated from water in Brazil was previously described as a hemorrhagic heat-labile cytotoxic-enterotoxin producer. We purified this toxin from culture supernatants using ion metallic affinity chromatography (IMAC) followed by molecular exclusion chromatography. The pure toxin presented molecular mass of 50 kDa and isoelectric point (pI) around 6.9 by 2D electrophoresis. When injected intravenously, the purified cytotoxic-enterotoxin induced also severe spasms followed by sudden death of mice. Hence, we entitled it as lethal cytotoxic-enterotoxin (LCE). The presence of membrane vesicles (MVs) on cell surfaces of P. shigelloides was observed by scan electron microscopy (SEM). From these MVs the LCE toxin was extracted and confirmed by biological and serological assays. These data suggest that P. shigelloides also exports this cytotoxic-enterotoxin by membrane vesicles, a different mechanism of delivering extra cellular virulence factors, so far not described in this bacterium. Keywords: Lethal cytotoxic enterotoxin (LCE), Membrane vesicles (MVs), Plesiomonas shigelloides, Toxin transportation, Virulence factors

This text addresses the importance of scientific collaboration networks in the context of open science, presenting the experience achieved within the International Academic Network WEIWER®. From this particular case, it will be possible to show that scientific entrepreneurship initiatives, based on collaborative research, are an effective way to overcome the individualism still present in many university institutions, e.g. due to their traditional or conventional features. Therefore, we aim to reflect on the contribution of these research networks to the policies that sustain the production and dissemination of scientific knowledge. In a current situation, in which there is a consolidation of the culture of openness, both at the governmental and academic levels, the WEIWER® experience allows us to conclude that networked research enables the construction of an open, collaborative and social space for science, respecting the autonomy, reflection and independence of each researcher. In short, we argue that in the context of open science, these research networks contribute to promote the construction of knowledge in collective settings, creating enriching dialogues and understandings on the complexity of both the research objects and designs dealt with.

On 23/12/2009, windstorm Xola struck mainland Portugal, causing serious damage in a small area north of Lisbon (Oeste region) and in the south region, inflicting economic losses of over EUR 100 million. In both areas, several power towers, designed to withstand up to 46 m s−1 winds, were destroyed. The causes of these two distinct damaging wind events were investigated. Xola was revealed to have a prominent cloud head and a split cold front structure. In the southern region, the damages were due to downburst winds, associated with a mesovortex, observed in a bow echo line triggered by an upper cold front. The cloud head presented several dry air intrusion signatures, co-located with tops progressively lowering towards the hooked tip. This tip revealed features consistent with the presence of slantwise convection, the descending branches of which may have been strengthened by evaporating cooling. At the reflectivity cloud head tip, a jet streak pattern was identified on weather radar, with Doppler velocities exceeding 55 m s−1, just 400 m above ground. This signature is coherent with the presence of a Sting jet, and this phenomenon was associated with the strongest wind gusts (over 40 m s−1) and the largest damages in the Oeste region.

From 2000 onwards, a systematic documentation of tornado reports was maintained at the Portuguese Meteorological Service (IPMA). The characteristics of 195 tornado events over land and at sea off the coast of mainland Portugal, Azores, and Madeira Islands, reported until 2020, were compiled into a new tornado database for Portugal. Each event was identified through the direct observation of the vortex, photography or video footage, or eyewitness descriptions, as well as by site surveys, including the interpretation of traces of the tornado found on the ground. For events after 2006, each data record was complemented with Doppler radar observations and derived products, which allowed a tornado type (TT) classification. The synoptic regimes and atmospheric environments favoring each type were identified using observations and numerical weather prediction model data. Results showed that tornadoes over Portugal were more frequent during autumn, winter, and spring. It was found that the occurrence of more than one tornado on the same day was frequent. The most intense tornadoes, classified as F3 intensity, were spawned by supercells, but a large proportion of weaker, shorter-lived, but still damaging tornadoes were found to be spawned in association with quasi linear convective systems (QLCS).

Artykuł ten został przygotowany przez międzynarodowy zespół badaczy reprezentujący różne obszary nauki związane z ICT, e-learningiem, pedagogiką oraz innymi dyscyplinami. Tekst skupia się na celach oraz wybranych wynikach międzynarodowego projektu IRNet (www.irnet.us.edu.pl). Szczególną uwagę skoncentrowano na opisie narzędzi, metod i procedur badawczych wykorzysta-nych podczas realizacji Pakietu WP7 „Rozpowszechnienie wyników projektu”, to znaczy na celach, zadaniach, rezultatach, publikacjach oraz realizacji wyjazdów naukowych w kontekście kolejnych etapów oraz pakietów projektu IRNet.

Animal models commonly serve as a bridge between in vitro experiments and clinical applications; however, few physiological processes in adult animals are sufficient to serve as proof-of-concept models for cartilage regeneration. Intriguingly, some rodents, such as young adult mice, undergo physiological connective tissue modifications to birth canal elements such as the pubic symphysis during pregnancy; therefore, we investigated whether the differential expression of cartilage differentiation markers is associated with cartilaginous tissue morphological modifications during these changes. Our results showed that osteochondral progenitor cells expressing Runx2, Sox9, Col2a1 and Dcx at the non-pregnant pubic symphysis proliferated and differentiated throughout pregnancy, giving rise to a complex osteoligamentous junction that attached the interpubic ligament to the pubic bones until labour occurred. After delivery, the recovery of pubic symphysis cartilaginous tissues was improved by the time-dependent expression of these chondrocytic lineage markers at the osteoligamentous junction. This process potentially recapitulates embryologic chondrocytic differentiation to successfully recover hyaline cartilaginous pads at 10 days postpartum. Therefore, we propose that this physiological phenomenon represents a proof-of-concept model for investigating the mechanisms involved in cartilage restoration in adult animals.

The emergence of infections associated to new antimicrobial resistance in Acinetobacter baumannii (Ab) genotypes represents a major challenge. In this context, this study aimed to determine the diversity of resistance mechanisms and investigate clonal dissemination and predominant sequence types (STs) in multidrug-resistant Ab strains of clinical (tracheal aspirate, n = 17) and environmental (surface, n = 6) origins. Additionally, the major clones found in clinical (A) and environmental (H) strains had their complete genomes sequenced. All strains were submitted to polymerase chain reactions (PCR) for the detection of the ISAba1/blaOXA-51-like and ISAba1/blaOXA-23-like genes, while the expression of genes encoding the carO porin, AdeABC (adeB), AdeFGH (adeG), and AdeIJK (adeJ) efflux pumps was determined by real time PCR (qPCR). Most of the strains were characterized as extensively drug-resistant (XDR) with high minimal inhibitory concentrations (MICs) detected for tigecycline and carbapenems. Associations between ISAba1/OXA-51 and ISAba1/OXA-23 were observed in 91.3% and 52.2% of the strains, respectively. Only the adeB gene was considered hyper-expressed. Furthermore, most of the strains analyzed by the MuLtilocus Sequence-Typing (MLST) were found to belong to the clonal complex 113 (CC113). In addition, a new ST, ST1399, belonging to CC229, was also discovered herein. Strains analyzed by whole genome sequencing presented resistance genes linked to multidrug-resistance phenotypes and confirmed the presence of Tn2008, which provides high levels carbapenem-resistance.

This study presents experimental results on the behaviour of aluminium alloy metal structures and foams manufactured by lost-wax casting and using 3D printed components for internal structure definition. Results for tensile tests, metallurgical properties, surface quality and geometry tolerances were obtained and discussed. The analysis focused on development geometries, used for adjusting manufacturing parameters and prototype geometries intended for geometrical and mechanical validation. The results are indicative of the viability of the method for producing foam structures suitable for mechanical loading.

Aim: We assessed late onset sepsis (LOS) rates of neonates in a neonatal intensive care unit (NICU) before and after implementing an evidence-based bundle to prevent these infections in a country with poor resources. Methods: We evaluate trends of LOS between October 2010 and August 2012 in a large tertiary hospital in Brazil. We designed a protocol based of CDC guidelines for insertion of maintenance of central venous catheter targeted to reduction of bloodstream infections. During this period two major events occurred: a great increase of LOS rates in January months and relocation of the unit to a provisory place. Additionally we evaluated the risk factors and etiology of these infections. Results: A total of 112 (20.3%) cases defined as LOS were found. The overall incidence rate of LOS in the study was 16.1/1000 patient/days and 23.0/1000 CVC-days. Our monthly rates data of LOS/1000 patient-day reveal fluctuations over the studied period, with incidence rates of these infections in staff vacation period (January 2011 and 2012) significantly higher (59.6/1000 patients-days) than compared with the other months rates (16.6/1000 patients-days) (IRR = 3.59; p

Niniejszy artykuł, przygotowany przez zespół badaczy specjalizujących się w różnych dziedzi-nach naukowych związanych z technologiami komunikacyjnymi i informacyjnymi, pedagogiką oraz dyscyplinami pokrewnymi, przedstawia cele i niektóre rezultaty badań przeprowadzonych w ramach międzynarodowego projektu IRNet (www.irnet.us.edu.pl). W szczególności opisane zostały narzę-dzia badawcze, metody, a także procedury zawarte w pakiecie zadań nr 6 „Wdrożenie metodologii”. W artykule omówiono cele, wykonane zadania, wyniki, publikacje, spotkania naukowe oraz kolejne etapy prac i przedsięwzięć projektowych.

The bacterial factors associated with bacteremia by multidrug-resistant and extensively drug-resistant P. aeruginosa, including overexpression of efflux pumps, AmpC overproduction, and loss/alteration of the OprD porin in isolates that are non-Metallo-β-Lactamase producing were analyzed in a retrospective study. Molecular analyses included strain typing by Pulsed Field Gel Electrophoresis and identification of key genes via qualitative and quantitative PCR-based assays. Previous use of carbapenems and tracheostomy was independently associated with the development of bacteremia by extensively drug-resistant and multidrug-resistant strains of P. aeruginosa. A high consumption of antimicrobials was observed, and 75.0% of the isolates contained amplicons with the blaSPM-1 and blaVIM genes. Of the 47 non-Metallo-β-Lactamase isolates, none had another type of carbapenemase. However, the isolates exhibited high rates of hyperproduction of AmpC, loss of the OprD porin (71.4%) and the presence of MexABOprM (57.1%) and MexXY (64.3%). This study suggests that in non-Metallo-β-Lactamase isolates, the association of intrinsic resistance mechanisms could contributes to the expression of multidrug-resistant/extensively drug-resistant phenotypes.

Abstract:INTRODUCTION:The frequency of methicillin-resistant Staphylococcus aureus (MRSA) has increased in the community. This study evaluated the prevalence of MRSA and community-acquired (CA)-MRSA in 120 healthy elderly.METHODS:The MRSA were evaluated for the presence of the IS256, mecA, agr, icaA, icaD, fnbB , and pvl genes with PCR. Results: Frequency of S. aureus and MRSA colonization was 17.8% and 19%, respectively. CA-MRSA isolate showed SCC mec IV, fnbB+ , and icaD+ .CONCLUSIONS:CA-MRSA was detected, with genotype determined as SCC mec type IV/IS256/ fnbB+ / icaA / icaD+ / bbp-/agr2 / bap / pvl, characterizing this population as a possible reservoir of this organism in the community.

Introduction Methicillin-resistant Staphylococcus aureus (MRSA) is among the most important pathogens of nosocomial infections, mainly in intensive care units (ICUs), and accounts for 40-60% of all healthcare-associated S. aureus infections. We evaluated the incidence of nosocomial infection by S. aureus, identified the risk factors for MRSA infection, and evaluated the effect of resistance to methicillin on mortality in patients. Methods We conducted MRSA surveillance at a university hospital in Brazil from January 1, 2010, to December 31, 2010, and performed a retrospective case-control matched study to evaluate the frequency of subsequent MRSA bacteremia and death among patients. We evaluated and compared the risk factors between patients with MRSA and methicillin-sensitive Staphylococcus aureus (MSSA) infection. Results Sepsis was the most common cause of infection (17.7/1,000 patient-days), followed by surgical site (11.4/1,000 patient-days), pneumonia (4.1/1,000 patient-days), and urinary tract infection (2.4/1,000 patient-days). The significant risk factors were time of hospitalization, use of central vascular catheter (CVC), urinary catheter, nasogastric tube, parenteral nutrition, tracheostomy, mechanical ventilation, and previous antibiotic administration, the latter of which was the only independent risk factor for MRSA infection. Mortality was significantly higher in patients with MRSA. The number of antibiotics tested was not related to increases in the frequency of MRSA/1,000 patient-days. The incidence of mortality attributable to MRSA (bloodstream infection) BSI was 50%. Conclusions Surveillance results showed that the use of high levels of antibiotics was directly related to the development of MRSA infection, and the mortality attributable to MRSA in patients with bacteremia was significant.

OBJECTIVE: to compare the degree of bacterial contamination of surgical instrument tables used in clean surgical procedures, either protected with plastic fields, sterilized with ethylene oxide, or disinfected with 70% alcohol and 1% iodine solutions. This is a randomized clinical trial in which samples were collected from the surfaces of surgical instrument tables before and after each procedure. Microbiological analysis was performed to identify microorganisms and their respective antimicrobial resistance. RESULTS: Bacterial growth in the surgeries using sterilized plastic was 5.71% before and 28.6% after surgery and, 2.9% and 45.7% respectively in surgeries using disinfection with 70% alcohol and 1% iodine solutions; no statistical difference was found between the methods. CONCLUSION: both methods present similar protection, however, 70% alcohol and 1% iodine do not generate solid waste.El objetivo del estudio fue analizar el grado de contaminación bacteriana de la mesa de instrumentos quirúrgicos en dos casos, después del uso: cubierta protectora plástico de la mesa quirúrgica esterilizada con óxido de etileno o desinfección con solución de alcohol a 70% y yodo a 1%, en procedimientos quirúrgicos limpios. Se trata de un experimento clínico aleatorio, con recolección de muestras de las superficies de las mesas de instrumentos quirúrgicos, antes y después de cada procedimiento, con posterior análisis microbiológica para identificar los microorganismos y la resistencia antimicrobiana. En las cirugías en que el plástico esterilizado fue utilizado, el crecimiento bacteriano fue de 5,71% antes y 28,6% después de la cirugía, en cuanto que en las desinfecciones con solución de alcohol a 70% y yodo a 1%, el crecimiento fue de 2,9% antes y 45,7% después, lo que indica que no hubo diferencia significativa entre los métodos empleados. Los dos métodos tienen poder de protección semejante, considerando que el alcohol a 70% y yodo a 1% no generan residuos sólidos.OBJETIVO: analisar o grau de contaminação bacteriana da mesa de instrumentais cirúrgicos, após o uso de campo plástico esterilizado por óxido de etileno ou a desinfecção com solução de álcool a 70% e iodo a 1%, em procedimentos cirúrgicos limpos. MÉTODOS: Trata-se de experimento clínico randomizado, com coletas de amostras das superfícies das mesas de instrumentais cirúrgicos, antes e depois de cada procedimento, com posterior análise microbiológica para identificação dos microrganismos e sua resistência antimicrobiana. RESULTADOS: nas cirurgias em que o plástico esterilizado foi utilizado, o crescimento bacteriano foi de 5,71% antes e 28,6% após a cirurgia, enquanto que nas desinfecções com solução de álcool a 70% e iodo a 1%, o crescimento foi de 2,9% antes e 45,7% após, sem diferença significativa entre os métodos empregados. CONCLUSÕES: os dois métodos têm poder de proteção semelhante, considerando que o álcool a 70% e iodo a 1% não geram resíduos sólidos.

INTRODUCTION : Antimicrobial resistance is an increasing threat in hospitalized patients, and inappropriate empirical antimicrobial therapy is known to adversely affect outcomes in ventilator-associated pneumonia (VAP). The aim of this study was to evaluate antimicrobial usage, incidence, etiology, and antimicrobial resistance trends for prominent nosocomial pathogens causing ventilator-associated pneumonia in a clinical-surgical intensive care unit (ICU). METHODS : Gram-negative bacilli and Staphylococcus aureus causing VAP, as well as their antimicrobial resistance patterns and data on consumption (defined daily dose [DDD] per 1,000 patient days) of glycopeptides, extended-spectrum cephalosporins, and carbapenems in the unit were evaluated in two different periods (A and B). RESULTS: Antimicrobial use was high, mainly of broad-spectrum cephalosporins, with a significant increase in the consumption of glycopeptides (p < 0.0001) and carbapenems (p < 0.007) in period B. For Acinetobacter baumannii and members of the Enterobacteriaceae family, 5.27- and 3.06-fold increases in VAPs, respectively, were noted, and a significant increase in resistance rates was found for imipenem-resistant A. baumannii (p = 0.003) and third-generation cephalosporins-resistant Enterobacteriaceae (p = 0.01) isolates in this same period. CONCLUSIONS: Our results suggest that there is a link between antibiotics usage at institutional levels and resistant bacteria. The use of carbapenems was related to the high rate of resistance in A. baumannii and therefore a high consumption of imipenem/meropenem could play a major role in selective pressure exerted by antibiotics in A. baumannii strains.

INTRODUCTION: Antimicrobial resistance is an increasing threat in hospitalized patients, and inappropriate empirical antimicrobial therapy is known to adversely affect outcomes in ventilator-associated pneumonia (VAP). The aim of this study was to evaluate antimicrobial usage, incidence, etiology, and antimicrobial resistance trends for prominent nosocomial pathogens causing ventilator-associated pneumonia in a clinical-surgical intensive care unit (ICU). METHODS: Gram-negative bacilli and Staphylococcus aureus causing VAP, as well as their antimicrobial resistance patterns and data on consumption (defined daily dose [DDD] per 1,000 patient days) of glycopeptides, extended-spectrum cephalosporins, and carbapenems in the unit were evaluated in two different periods (A and B). RESULTS: Antimicrobial use was high, mainly of broad-spectrum cephalosporins, with a significant increase in the consumption of glycopeptides (p < 0.0001) and carbapenems (p < 0.007) in period B. For Acinetobacter baumannii and members of the Enterobacteriaceae family, 5.27- and 3.06-fold increases in VAPs, respectively, were noted, and a significant increase in resistance rates was found for imipenem-resistant A. baumannii (p = 0.003) and third-generation cephalosporins-resistant Enterobacteriaceae (p = 0.01) isolates in this same period. CONCLUSIONS: Our results suggest that there is a link between antibiotics usage at institutional levels and resistant bacteria. The use of carbapenems was related to the high rate of resistance in A. baumannii and therefore a high consumption of imipenem/meropenem could play a major role in selective pressure exerted by antibiotics in A. baumannii strains.

The 70 kDa heat shock protein (HSP70) is a molecular chaperone that assists the parasite Leishmania in returning to homeostasis after being subjected to different types of stress during its life cycle. In the present study, we evaluated the effects of HSP70 transfection of L. amazonensis promastigotes (pTEX-HSP70) in terms of morphology, resistance, infectivity and mitochondrial bioenergetics. The pTEX-HSP70 promastigotes showed no ultrastructural morphological changes compared to control parasites. Interestingly, the pTEX-HSP70 promastigotes are resistant to heat shock, H2O2-induced oxidative stress and hyperbaric environments. Regarding the bioenergetics parameters, the pTEX-HSP70 parasites had higher respiratory rates and released less H2O2 than the control parasites. Nevertheless, the infectivity capacity of the parasites did not change, as verified by the infection of murine peritoneal macrophages and human macrophages, as well as the infection of BALB/c mice. Together, these results indicate that the overexpression of HSP70 protects L. amazonensis from stress, but does not interfere with its infective capacity.

We described a comprehensive analysis of the molecular epidemiology of multidrug-resistant (MDR) P. aeruginosa. Molecular analysis included typing by Pulsed Field Gel Electrophoresis, identification of genes of interest through PCR-based assays and sequencing of target genes. Case-control study was conducted to better understand the prognostic of patients and the impact of inappropriate therapy in patients with bacteremia, as well as the risk factors of MDR infections. We observed a high rate of MDR isolates (40.7%), and 51.0% of them was independently associated with inappropriate antibiotic therapy. Bacteremia was detected in 66.9% of patients, and prolonged hospital stay was expressive in those resistant to fluoroquinolone. Plasmid-mediated quinolone resistance genes (PMQR), qnrS1 and aac(6')Ib-cr, were detected in two different nosocomial isolates (5.3%), and the aac(6')-Ib7 variant was detected at a high frequency (87.5%) in those negative to PMQR. The presence of mutations in gyrA and parC genes was observed in 100% and 85% of selected isolates, respectively. Isolates harboring PMQR genes or mutations in gyrA and parC were not closely related, except in those containing SPM (São Paulo metallo-β-lactamase) clone. In addition, there is no study published in Brazil to date reporting the presence of Pseudomonas aeruginosa isolates harboring both qnrS1 and aac(6')Ib-cr genes, with alarming frequency of patients with inappropriate therapy.

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.

Multidrug-resistant (MDR) Acinetobacter baumannii (Acb) is a rapidly emerging pathogen in healthcare settings. The aim of this study was to evaluate the predictors of poor outcome in patients with MDR Acb. This is the first report documenting factors influencing survival in patients with MDR Acb in this tertiary hospital. This study is a prospective of the hospital epidemiology database. A total of 73 patients with 84 Acb isolates were obtained between August 2009 and October 2010 in this hospital. In the present study, the 30-day mortality rate was 39.7%. Of 84 Acb isolates, 50 (59%) were MDR, nine (11%) were pan-resistant, and 25 (30%) were non-MDR. The non-MDR isolates were used as the control group. The factors significantly associated with multidrug resistance included previous surgeries, presence of comorbidity (renal disease), use of more than two devices, parenteral nutrition, and inappropriate antimicrobial therapy. Significant predictors of 30-day mortality in the univariate analysis included pneumonia, diabetes mellitus, renal disease, use of more than two devices, and inappropriate antimicrobial therapy administered within two days of the onset of infection. The factors associated with mortality in patients with MDR Acb infection in this study were: age ≥ 60 years, pneumonia, diabetes mellitus, renal disease, use of more than two invasive procedures, and inappropriate antimicrobial therapy. Vigilance is needed to prevent outbreaks of this opportunistic and deadly pathogen. Keywords: Multidrug-resistant, Acinetobacter baumannii, Gram-negative bacteria

INTRODUCTION: Methicillin-resistant Staphylococcus aureus (MRSA) is spread out in hospitals across different regions of the world and is regarded as the major agent of nosocomial infections, causing infections such as skin and soft tissue pneumonia and sepsis. The aim of this study was to identify risk factors for methicillin-resistance in Staphylococcus aureus bloodstream infection (BSI) and the predictive factors for death. METHODS: A retrospective cohort of fifty-one patients presenting bacteraemia due to S. aureus between September 2006 and September 2008 was analysed. Staphylococcu aureus samples were obtained from blood cultures performed by clinical hospital microbiology laboratory from the Uberlândia Federal University. Methicillinresistance was determined by growth on oxacillin screen agar and antimicrobial susceptibility by means of the disk diffusion method. RESULTS: We found similar numbers of MRSA (56.8%) and methicillin-susceptible Staphylococcus aureus (MSSA) (43.2%) infections, and the overall hospital mortality ratio was 47%, predominantly in MRSA group (70.8% vs. 29.2%) (p=0.05). Age (p=0.02) was significantly higher in MRSA patients as also was the use of central venous catheter (p=0.02). The use of two or more antimicrobial agents (p=0.03) and the length of hospital stay prior to bacteraemia superior to seven days (p=0.006) were associated with mortality. High odds ratio value was observed in cardiopathy as comorbidity. CONCLUSIONS: Despite several risk factors associated with MRSA and MSSA infection, the use of two or more antimicrobial agents was the unique independent variable associated with mortality.

INTRODUCTION: his study evaluated the consumption of major classes of antibiotics, the colonization of the oropharynx of patients on mechanical ventilation, and the risk of ventilator-associated pneumonia (VAP) caused by Staphylococcus aureus in an intensive care unit for adults. METHODS: A case-control study was carried out using colonized patients (cases) by oxacillin-resistant S. aureus (ORSA) and (controls) oxacillin-sensitive S. aureus (OSSA) from May 2009 to August 2010. The occurrence of VAP by S. aureus was also evaluated in the same period. Antibiotic consumption was expressed as the number of defined daily doses (DDD)/1,000 patient-days for glycopeptides, carbapenems, and extended-spectrum cephalosporins. RESULTS: Three hundred forty-six (56.1%) patients underwent mechanical ventilation with a frequency of oropharyngeal colonization of 36.4%, corresponding to 63.5% for ORSA and 36.5% for OSSA. The risk of illness for this organism was significant (p60 years, previous antibiotic therapy, and previous use of carbapenems were statistically significant by multivariate analysis. CONCLUSIONS: There was a significant relationship between the colonization of the oropharyngeal mucosa and the risk of VAP by both phenotypes. The use of glycopeptides was related to colonization by ORSA.

Vancomycin-resistant enterococci (VRE) are important hospital pathogens and have become increasingly common in patients admitted to the intensive care unit (ICU). To determine the incidence and the risk factors associated with VRE colonisation among ICU patients, active surveillance cultures for VRE faecal carriages were carried out in patients admitted to the ICU of the University Hospital of Uberlândia, Minas Gerais, Brazil. Risk factors were assessed using a case-control study. Seventy-seven patients (23.1%) were found to be colonised with vanC VRE and only one patient (0.3%) was colonised with vanA VRE. Independent risk factors for VRE colonisation included nephropathy [odds ratio (OR) = 13.6, p < 0.001], prior antibiotic use (OR = 5.5, p < 0.03) and carbapenem use (OR = 17.3, p < 0.001). Our results showed a higher frequency (23.1%) of Enterococcus gallinarum and Enterococcus casseliflavus, species that are intrinsically resistant to low levels of vancomycin (vanC), without an associated infection, associated with prior antibiotic use, carbapenem use and nephropathy as comorbidity. This study is the first to demonstrate the risk factors associated with vanC VRE colonisation in ICU hospitalised patients. Although vanA and vanB enterococci are of great importance, the epidemiology of vanC VRE needs to be better understood. Even though the clinical relevance of vanC VRE is uncertain, these species are opportunistic pathogens and vanC VRE-colonised patients are a potential epidemiologic reservoir of resistance genes.

INTRODUCTION: Catheter-associated bloodstream infection (CA-BSI) is the most common nosocomial infection in neonatal intensive care units. There is evidence that care bundles to reduce CA-BSI are effective in the adult literature. The aim of this study was to reduce CA-BSI in a Brazilian neonatal intensive care unit by means of a care bundle including few strategies or procedures of prevention and control of these infections. METHODS: An intervention designed to reduce CA-BSI with five evidence-based procedures was conducted. RESULTS: A total of sixty-seven (26.7%) CA-BSIs were observed. There were 46 (32%) episodes of culture-proven sepsis in group preintervention (24.1 per 1,000 catheter days [CVC days]). Neonates in the group after implementation of the intervention had 21 (19.6%) episodes of CA-BSI (14.9 per 1,000 CVC days). The incidence of CA-BSI decreased significantly after the intervention from the group preintervention and postintervention (32% to 19.6%, 24.1 per 1,000 CVC days to 14.9 per 1,000 CVC days, p=0.04). In the multiple logistic regression analysis, the use of more than 3 antibiotics and length of stay >8 days were independent risk factors for BSI. CONCLUSIONS: A stepwise introduction of evidence-based intervention and intensive and continuous education of all healthcare workers are effective in reducing CA-BSI.

INTRODUCTION: The purpose of this study was to establish the late onset sepsis (LOS) rate of our service, characterize the intestinal microbiota and evaluate a possible association between gut flora and sepsis in surgical infants who were receiving parenteral nutrition (PN). METHODS: Surveillance cultures of the gut were taken at the start of PN and thereafter once a week. Specimens for blood culture were collected based on clinical criteria established by the medical staff. The central venous catheter (CVC) tip was removed under aseptic conditions. Standard laboratory methods were used to identify the microorganisms that grew on cultures of gut, blood and CVC tip. RESULTS: 74 very low birth weight infants were analyzed. All the infants were receiving PN and antibiotics when the gut culture was started. In total, 21 (28.4%) infants experienced 28 episodes of LOS with no identified source. Coagulase negative staphylococci were the most common bacteria identified, both in the intestine (74.2%) and blood (67.8%). All infections occurred in patients who received PN through a central venous catheter. Six infants experienced episodes of microbial translocation. CONCLUSIONS: In this study, LOS was the most frequent episode in neonates receiving parenteral nutrition who had been submitted to surgery; 28.6% of this infection was probably a gut-derived phenomenon and requires novel strategies for prevention.

INTRODUCTION: Report the incidence of nosocomial infections, causative microorganisms, risk factors associated with and antimicrobial susceptibility pattern in the NICU of the Uberlândia University Hospital. METHODS: Data were collected through the National Healthcare Safety Network surveillance from January 2006 to December 2009. The patients were followed five times/week from their birth to their discharge or death. RESULTS: The study included 1,443 patients, 209 of these developed NIs, totaling 293 NI episodes, principally bloodstream infections (203; 69.3%) and conjunctivitis (52; 17.7%). Device-associated infection rates were as follows: 17.3 primary bloodstream infections per 1,000 central line-days and 3.2 pneumonias per 1000 ventilator-days. The mortality rate in neonates with NI was 11.9%. Mechanical ventilation, total parenteral nutrition, orogastric tube, previous antibiotic therapy, use of CVC and birth weight of 751-1,000g appeared to be associated with a significantly higher risk of NI (p < 0.05). In multiple logistic regression analysis for NI, mechanical ventilation and the use of CVC were independent risk factors (p < 0.05). Coagulase- negative Staphylococcus (CoNS) (36.5%) and Staphylococcus aureus (23.6%) were the most common etiologic agents isolated from cultures. The incidences of oxacillin-resistant CoNS and S. aureus were 81.8% and 25.3%, respectively. CONCLUSIONS: Frequent surveillance was very important to evaluate the association of these well-known risk factors with NIs and causative organisms, assisting in drawing the attention of health care professionals to this potent cause of morbidity.INTRODUÇÃO: Relatar a incidência das infecções hospitalares, microrganismos causadores, fatores de risco associados e o padrão de susceptibilidade aos antimicrobianos na UTI neonatal do Hospital Universitário de Uberlândia. MÉTODOS: Realizou-se vigilância National Healthcare Safety Network de janeiro de 2006 a dezembro de 2009. Os pacientes foram acompanhados cinco vezes por semana desde o seu nascimento até a alta ou óbito. RESULTADOS: O estudo incluiu 1.443 pacientes dos quais 209 desenvolveram infecção hospitalar, totalizando 293 episódios de IHs, com destaque para as infecções de corrente sanguínea (203; 69,3%) e conjuntivite (52; 17,7%). As taxas de infecção associadas a dispositivos foram as seguintes: 17,3 infecções da corrente sanguínea primária por 1.000 CVC dia e 3,2 pneumonias por 1.000 ventiladores-dia. A taxa de mortalidade em recém-nascidos com infecções hospitalares foi de 11,9%. A ventilação mecânica, nutrição parenteral total, sonda orogástrica, antibioticoterapia prévia, uso de CVC e peso de 751-1.000g pareceu estar associado com um risco significativamente maior de IH (p < 0,05). Na análise de regressão logística múltipla para IH, ventilação mecânica e uso de CVC foram fatores de risco independentes (p < 0,05). Staphylococcus coagulase-negativo (SCoN) (36,5%) e Staphylococcus aureus (23,6%) foram os agentes etiológicos mais comumente isolados. A incidência de SCoN e S. aureus resistente à oxacilina foram de 81,8% e 25,3%, respectivamente. CONCLUSÕES: Uma vigilância frequente foi importante para avaliar a associação de fatores de risco bem conhecidos com as IHs e etiologia com a finalidade de chamar a atenção dos profissionais de saúde para esta grande causa de morbidade.

INTRODUÇÃO: Avaliou-se o nível da contaminação do ar em cirurgias ortopédicas. MÉTODOS: O ar das salas cirúrgicas foi analisado microbiologicamente através da exposição de placas próximas à mesa cirúrgica por uma hora. RESULTADOS: Foram evidenciados valores acima do recomendado (369 UFC/m³) nas salas convencionais, assim como naquelas com ar ultralimpo. A contaminação foi predominantemente por Staphylococcus sp (86,9%). verificou-se um número alto de pessoas presentes no interior das salas cirúrgicas, assim como de abertura da porta. CONCLUSÕES: Os níveis de contaminação se apresentaram acima dos valores aceitos por agências reguladoras, representando risco para os pacientes.INTRODUCTION: The air contamination levels during orthopedic surgeries were evaluated. METHODS: The air of operating rooms (ORs) was examined through exposure to microbiological plates placed near the surgical table for an hour. RESULTS: values above that recommended (369 CFU/m³) for conventional ORs and ORs with ultraclean air were determined. Contamination was predominantly by Staphylococcus sp (86.9%). In all surgeries a high number of people were present inside the ORs and the doors were opened frequently. CONCLUSIONS: The contamination levels are above the values accepted by regulatory agencies, representing risk for patients.

Os objetivos desse estudo foram investigar a participação de Candida albicans e não-albicans como agente de colonização e sepse, bem como os fatores de risco associados aos neonatos internados na Unidade de Terapia Intensiva Neonatal do Hospital de Clínicas da Universidade Federal de Uberlândia. Foi realizada vigilância epidemiológica pelo sistema National Healthcare Safety Network no período entre agosto de 2007 e abril de 2008. A taxa de incidência de sepse com critério microbiológico foi de 6,7/1.000 paciente/dia, constatando-se apenas um caso de candidemia. Aproximadamente, 19% dos neonatos estavam colonizados por Candida, identificadas como Candida albicans (50%) e Candida não-albicans (50%). Os fatores de risco significantes para colonização por Candida spp foram a idade gestacional entre 26 e 30 semanas, o uso prévio de antibiótico e o cateter vascular central umbilical. A mortalidade total foi de 11,8% nos neonatos internados durante o período de estudo com sepse, porém o recém-nascido com candidemia não evoluiu para óbito.The objectives of this study were to investigate the participation of Candida albicans and non-albicans as colonization and sepsis agents, along with the risk factors associated with the neonates in the neonatal intensive care unit of the clinical hospital of the Federal University of Uberlândia. Epidemiological surveillance was implemented through the National Healthcare Safety Network between August 2007 and April 2008. The incidence rate for sepsis with microbiological criteria was 6.7/1,000 patients/day, which was shown as only one case of candidemia. Approximately 19% of the neonates were colonized by Candida, which was identified as Candida albicans (50%) and Candida not-albicans (50%). The significant risk factors for Candida spp colonization were gestational age of between 26 and 30 weeks, previous antibiotic use and umbilical central vascular catheter. The overall mortality among the neonates hospitalized with sepsis over the study period was 11.8%. However, the neonate with candidemia did not die.

This article analyzes the role of religious identities in the constitution and negotiation of the cultural differences and social position of the Arabic-speaking immigrants in Brazil since the end of the nineteenth century. Religious identity was an important form of social classification for both the immigrants and the Brazilian society. Among the immigrants, affiliation to one of the many religious communities present in the Middle East provided access to institutions and networks of solidarity within the larger group of Arabic-speaking immigrants in Brazil. Conversely, conversion to Catholicism was an important element in the process of cultural integration that was expected to accompany upwards social mobility in the Brazilian society. Religious imaginaries and religious identities were intertwined with the ethnic and national identities that the Arabic-speaking immigrants mobilized in order to build a community and negotiate their presence in the Brazilian society. Therefore, this analysis will focus on in the role of religious traditions and institutions in the ways through which Arab, Syrian-Lebanese and Palestinian ethnicity have been negotiated, transmitted and reinvented in Brazil.

This article, prepared by an international team of researchers from different scientific areas, connected with ICT, e-learning, pedagogy, and other related disciplines, focuses on the objectives and some results of the international project IRNet. In particular, the article describes research tools, methods, and a procedure of the WP2, that is, analyses of legal, ethical, human, technical, and social factors of ICT and e-learning development, and the state of intercultural competences in partner countries: objectives, tasks, deliverables, and implementation of research trips. Researchers from Poland, the Netherlands, Spain, Slovakia, Portugal, Czech Republic, Australia, Ukraine, and Russia analyzed the results of WP2 in the context of the next stages and Work packages of IRNet project – International Research Network.

This article, prepared by an international team of authors – researchers from different scientific areas, connected with ICT, e-learning, pedagogy, and other related disciplines – focuses on the objectives and some results of the IRNet international project. In particular, this article describes the research tools, methods and some procedures of the WP3 “Analyses and Evaluation of the ICT Level, E-learning and Intercultural Development in Every Participating Country”: Objectives, Tasks, Deliverables, and implementation of research trips. Except that, the article presents more important events, such as (video)conferences, seminars, workshops, an e-round table debate; among these events are ICTE2014, DLCC2014, “New Educational Strategies in Modern Information Space,” “Hightech information educational environment,” during which some more important results of the project research were presented. The list of publications includes 32 papers and a manuscript with WP3 results. Researchers from Poland, Russia, Ukraine, the Netherlands, Spain, Slovakia, Portugal, Czech Republic and Australia analysed the results of WP3 in the context of the next stages and Work packages of IRNet project – International Research Network.

PURPOSE: To evaluate models of gastric material collection from Wistar rats with and without using proton pump inhibitors(PPIs). METHODS: Twenty-four rats underwent intraperitoneal omeprazol treatment, and other 12 received similar treatment with 0.9% saline. All animals underwent collection of gastric material samples, after stomach removal, by either biopsies, or aspirates, or swabs. Samples were bacteriologically processed in order to identify species and strains. Values are described as natural logarithm of colony former units per mL [Ln(CFU/mL)]. Kruskal-Wallis and Mann-Whitney non-parametric tests were used, and pOBJETIVO: Avaliar modelos de coleta de material gástrico de ratos da linhagem Wistar, com e sem o uso de inibidores de bomba de próton (IBPs). MÉTODOS: 24 ratos foram submetidos a tratamento com omeprazol intraperitoneal e 12 outros ratos receberam tratamento semelhante com solução salina a 0,9%. Os animais foram submetidos a coleta de amostras de material gástrico, após retirada do estômago, utilizando-se de biópsias, aspirados ou swabs. Os materiais obtidos foram processados bacteriologicamente para identificação de espécimes quanto ao gênero. Os valores são descritos em logaritmo natural das unidades formadoras de colônias por mL [Ln(UFC/mL)]. Utilizou-se os testes não-paramétricos de Kruskal-Wallis e Mann-Whitney, considerando-se p

INTRODUÇÃO: Sepse é considerada doença grave com alta mortalidade. O objetivo desse estudo foi determinar a incidência e evolução da sepse em pacientes críticos. MÉTODOS: Foi realizada vigilância prospectiva de sepse na Unidade de Terapia Intensiva de Adultos, de abril-dezembro de 2007. RESULTADOS: A frequência de pacientes/dia foi 442. Setenta e cinco (18,6%) pacientes tinham sepse; destes, 72% hospitalar. As taxas de sepse grave e choque séptico por paciente/dia foram 5,0 e 3,1, respectivamente. A mortalidade total foi 34,6%. Sessenta e um por cento dos casos tinham diagnóstico microbiológico. CONCLUSÕES: A sepse apresentou-se numa frequência maior, do que a usualmente descrita na literatura.INTRODUCTION: Sepsis is considered to be a severe disease with high mortality. The objective of this study was to determine the incidence and evolution of sepsis among critically ill patients. METHODS: Prospective surveillance of sepsis was performed in the adult intensive care unit, between April and December 2007. RESULTS: The patient frequency/day was 442. Seventy-five patients (18.6%) had sepsis and 72% of these cases were hospital-acquired. The rates of severe sepsis and septic shock per patient/day were 5.0 and 3.1, respectively. The total mortality was 34.6% and 61% of the cases had microbiological diagnoses. CONCLUSIONS: Sepsis presented with higher frequency than is usually described in the literature.

Background. It is a fact that hand hygiene prevents nosocomial infection, but compliance with recommended instructions is commonly poor. The purpose of this study was to implement a hand hygiene program for increase compliance with hand hygiene and its relationship with nosocomial infection (NI) and MRSA infection/colonization rates. Methods. Compliance to hand hygiene was evaluated in a hospital by direct observation and measured of health care-associated infections, including methicillin resistant Staphylococcus aureus, before and after an educational intervention, using visual poster, colorful stamps, and feedback of the results. Results. Overall compliance did not increase during intervention, only handwashing before and after patient contact has improved from 40% to 76% (𝑃=0.01) for HCWs, but NI and MRSA rates remained high and stable. Conclusion. In a combination of high prevalence of NI and low compliance to hand hygiene, the programme of measure does not motivate the HCW hand hygiene. Future interventions should employ incremental evaluation to develop effective hand hygiene initiatives.