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
Efforts to monitor prevalence were hampered by failure to tag most cases with correct diagnostic codes.
Ministério estima vacinar 77,5 milhões de pessoas. Ampliação do programa de vacinação será gradual até abril de 2019; confira o cronograma.