Navegando por Palavras-chave "Hospital Infection"

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    Perfil de consumo de antibacterianos e correlação com multirresistência de bactérias isoladas em unidades críticas de um hospital de ensino de São Paulo
    (Universidade Federal de São Paulo (UNIFESP), 2021) Rattes, Alysson Leandro Ribeiro [UNIFESP]; Burattini, Marcelo Nascimento [UNIFESP]; Universidade Federal de São Paulo
    The evolution of multi resistance bacteria, resulting from selection pressure related to the inappropriate use of antibiotics, remains an alarming issue. OBJECTIVES: To analyze temporal trends in antibiotic consumption and its correlation with the development of antimicrobial resistance in first bacterial isolates of blood cultures from ten consecutive years. METHODS: observational, retrospective, single-center study carried out in a Brazilian tertiary university hospital. The correlation of temporal trends of antibiotic use (DDD/100 patient-day) with the rate of resistant isolates from selected bacteria first blood cultures were analyzed over ten years. RESULTS Cephalosporins were the most used class of antibiotics and presented the highest resistance profiles, with ceftriaxone being the most used antibiotic. However, there were different patterns of time trends relating the use of antibiotics and the development of bacterial resistance. There was an increase in resistance to A. baumannii (amikacin, ceftazidime, imipenem and piperacillin-tazobactam) and K. pneumoniae (cephalosporins, carbapenems, piperacillin-tazobactam, polymyxin, Tigecycline). K. pneumoniae showed a significant positive correlation between consumption and resistance for imipenem, meropenem, piperacillintazobactam, polymyxin, tigecycline and A. baumannii with ampicillin-sulbactam. CONCLUSION: There were significant correlations between antibiotic use and development of resistance, but with different evolution patterns related to the different bacteria and antibiotics analyzed which may imply different genetic mechanisms involved for Acinetobacter baumannii and Klebsiella pneumoniae.
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    Profilaxia Cirúrgica: Desenvolvimento De Aplicativo Para Dispositivos Móveis
    (Universidade Federal de São Paulo (UNIFESP), 2017-05-25) Coelho, Andre Afonso Machado [UNIFESP]; Gales, Ana Cristina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Objective: To develop an application for iPhone and iPad that assists in the selection of the appropriate antimicrobial for surgical prophylaxis. Methods: The application was developed using Xcode 7.2 in Swift 2.1 (Apple Inc.). The content was based on international recommendations regarding surgical prophylaxis, especially from the Infectious Diseases Society of America (IDSA). Results: The content was divided into six main links on the home screen, plus one for the referrals. The items "Antibioticoprophylaxis", "Table", "Doses", "Single dose" and "Protocols" are designed for a rapid bedside consultation, providing a concise answer on which antimicrobials (and their respective dosages) are recommended for a given procedure surgical. The "General Concepts" section has as its objective a conceptual deepening on topics relevant to surgical prophylaxis. In the topic "Antibioticoprofilaxia" were created sequential windows that direct the user to pages with each of the surgical procedures, where are the data related to the following items - type of procedure, microorganisms, first choice antibiotics, alternatives to beta-lactams and duration of prophylaxis. The dosages, half-lives and the interval for a new dose referring to the main antimicrobials used in surgical prophylaxis are shown on the link "Doses". The main advantages of using a single dose of prophylactic antimicrobial are highlighted in the topic "Single dose". In "Table" the first antimicrobial choice and two alternatives are presented for each type of surgery, besides the duration of the prophylaxis. The "Protocols" item has been designed for the user to insert the protocols of his own institution (in image format or PDF file) so that access to the general recommendations and those of his institution are in the same application, facilitating access, navigation and query. Finally, the "General Concepts" session is subdivided into 14 topics for further study on the following topics: surgery classification, decolonization and decontamination, renal and hepatic dysfunction, additional doses, indication of prophylaxis, current infection, resistant microorganisms, dose momentum preoperative, obesity, pediatrics, prophylaxis for prevention of endocarditis, prophylaxis for prevention of joint prosthesis infection, reoperation and hospitalized patients and treatment of surgical site infection. Conclusion: The application is expected to assist the attending physician in the most appropriate antimicrobial choice for each ix clinical situation, contributing to a better outcome for the patient and lower selective pressure in the hospital environment, thus reducing the emergence and maintenance of resistant bacterial strains, in addition to reducing hospital costs and the occurrence of adverse reactions.