Background: Carbapenem-resistant Klebsiella pneumoniae infections are increasingly prevalent in North American hospitals. We describe an outbreak of carbapenem-resistant K. pneumoniae containing the blaOXA-232 gene transmitted by contaminated duodenoscopes during endoscopic retrograde cholangiopancreatography (ERCP) procedures. Methods: An outbreak investigation was performed when 9 patients with blaOXA-232 carbapenem-resistant K. pneumoniae infections were identified at a tertiary care hospital. The investigation included 2 case-control studies, review of duodenoscope reprocessing procedures, and culture of devices. Carbapenem-resistant Enterobacteriacieae (CRE) isolates were evaluated with polymerase chain reaction analysis for carbapenemase genes, and isolates with the blaOXA-232 gene were subjected to whole-genome sequencing and chromosome single-nucleotide polymorphism analysis. On recognition of ERCP as a key risk factor for infection, targeted patient notification and CRE screening cultures were performed. Results: Molecular testing ultimately identified 17 patients with blaOxa-232 carbapenem-resistant K. pneumoniae isolates, including 9 with infections, 7 asymptomatic carriers who had undergone ERCP, and 1 additional patient who had been hospitalized in India and was probably the initial carrier. Two case-control studies established a point-source outbreak associated with 2 specific duodenoscopes. A field investigation of the use, reprocessing, and storage of deuodenoscopes did not identify deviations from US Food and Drug Administration or manufacturer recommendations for reprocessing. Conclusions: This outbreak demonstrated the previously underappreciated potential for duodenoscopes to transmit disease, even after undergoing high-level disinfection according to manufacturers’ guidelines.
Décadas de pesquisas mostraram que vacinas não causam transtornos do espectro autista (TEA). Mas o medo dessa conexão permanece. E um novo estudo publicado nesta segunda-feira (26) no Jama Pediatrics sugere que isso está fazendo com que famílias afetadas por autismo não vacinem suas crianças. • Vacina brasileira contra cocaína espera iniciar testes em humanos já […]
Meta-análise das pesquisas feitas com alunos brasileiros evidencia alta prevalência de ansiedade, depressão e uso de álcool
Combination therapy was not superior to monotherapy. The addition of meropenem tocolistin did not improve clinical failure in severe A baumannii infections. The trialwas unpowered to specifically address other bacteria.
Fonte: Colistin alone versus colistin plus meropenem for treatment of severe infections caused by carbapenem-resistant Gram-negative bacteria: an open-label, randomised controlled trial – The Lancet Infectious Diseases
A novel adjuvanted herpes zoster vaccine is likely to be more effective and cheaper than the live attenuated herpes zoster vaccine, a study found.
Infelizmente ainda não há previsão de sua comercialização no Brasil
SUS amplia o atendimento a essa doença que atinge o fígado e passa a oferecer remédios mais modernos e com menos efeitos colaterais