Navegando por Assunto "Neonatologia"

Agora exibindo 1 - 4 de 4

Acesso aberto (Open Access)
Aspectos clínicos, epidemiológicos, microbiológicos e terapêuticos da candidemia nosocomial em unidades neonatal e pediátrica em um hospital geral em Belém/ Pará
(Universidade Federal do Pará, 2006-06-13) PAES, Andréa Luzia Vaz; LEÃO, Raimundo Nonato Queiroz de; http://lattes.cnpq.br/2956764853618778; SOUZA, Rita Catarina Medeiros de
The fungals infections have been emerging as responsible for nosocomial infections, particularly when associates with morbities as prematureness, blood diseases, hospitable stay for more than 15 days, come in another. With the purpose of evaluating candidemia occurrence in patients of neonates and of the pediatrics put into hospital in public hospital in Belém / Pará, Fundação Santa Casa of Misericórdia from Pará (FSCMP), was accomplished a retrospective study having as investigation base all the cultures accomplished in hospital from January 1999 to December 2004. Of a total of 2.622 cultures, just five with C. albicans isolation of pediatrics and neonates patients. It is worth stress that it was not identified no other species of Candida. The children had between 0 until 9 months, and all of them were submitted for surgical procedures. Occurring other concomitant hospitable infections to candidemias. Among signals and symptoms introduced at the moment of the isolation of Candida note that respiratory disfunction and fever were the most frequent. Anemia and leukocytoses were the laboratories alterations predominant. Some risk factors for candidemia development were identified as antibiotics therapy, surgeries, blood transfusion, and use of blocking of H2, central veined catheter, probe pray-gastric. Among antibiotics used note that antibiotic of wide spectrum, like ceftazidime, imipenem, vancomycin, were used in most cases (4/5). The average time of hospitable stay belonged to 55 days, and three patient remained put into hospital in ICU. This work reflects a Candida's low isolation in children put into hospital in FSCMP, suggesting an improvement in the tests employees for mushrooms cultures.
Acesso aberto (Open Access)
Epidemiologia das infecções de corrente sanguínea por enterobactérias produtoras de betalactamase de espectro expandido: estudo caso-controle em Unidade Neonatal do Norte do Brasil
(Universidade Federal do Pará, 2012) SILVA, Danille Lima da; CARNEIRO, Irna Carla do Rosário Souza; http://lattes.cnpq.br/4389330944043163
Gram-negative bacilli, especially Enterobacteriacea, are frequently associated with neonatal sepsis. A retrospective case-control study was performed to study bloodstream infections (BSI) caused by extended-spectrum beta-lactamase-producing (ESBL) enterobacteria in a neonatal unit the northern region of Brazil. This research was undertaken of all neonates admitted between 1st January 2007 and 31st December 2011 to the neonatal care unit, who had late-onset sepsis with blood cultures positive for Klebsiella sp., Enterobacter sp., Serratia sp. and Escherichia coli, performed according to National Committee for Clinical Laboratory Standards criteria. There were 153 neonates with gram-negative septicaemia, 87 newborns were infected with ESBL-producing enterobacteria, with incidence of 8.63 cases per 1000 newborns admitted. These were studied 132 patients, divided in two groups, cases (ESBL +) and controls (ESBL -), of 66 each (1:1). Most cases were affected in the first days of life (34,8% vs. 9,1%, p=0,001), especially in 2007 (19,7%), and made use two antibiotics (59,1% vs. 33,3%, p=0,01). The control group made more use of central venous catheter (62,1% vs. 45,4%, p=0,037) and parenteral nutrition (75,7% vs. 48,5%, p=0,001). The distribution curve of enterobacteria in accordance with the production of ESBL throughout the study period showed a greater number of cases in 2007 and 2008 (56,05%), with a higher chance of acquiring ESBL-producing enterobacteria these years (78% e 72%, respectively), and a higher number of controls for 2010 and 2011 (72,7%). The evolution to more deaths occurred among the cases (40,9% vs. 24,2%, p=0,031) and the majority died within 30 days of the episode of ICS (92,6% vs. 50,0%, p=0,002). In multivariate analysis, the evolution to death by ESBL-producing remained as an independent variable (OR=3,47 IC 1,33 – 9,06). It was concluded that there was a higher incidence of ESBL-producing enterobacteria BSI for the first two years of the study (2007 - 2008), with probability of acquiring this type of infection of up to 78%. The neonatal mortality was high, being three times greater when compared to infections by non-ESBL-producing enterobacteria. The change of the resistance profile of BSI by enterobacteria, reducing the number of cases of ESBL over time was a result of the implementation of control measures for dissemination and selection of bacterial resistance in the neonatal unit, and coinciding with the revision of care protocols as increased use of PICC and parenteral nutrition protocol in the period from 2010 to 2011.
Acesso aberto (Open Access)
Fatores associados a letalidade na fungemia neonatal em UTI de hospital de ensino na Região Norte do Brasil
(Universidade Federal do Pará, 2011) MATTOS, Wardie Atallah de; BICHARA, Cléa Nazaré Carneiro; http://lattes.cnpq.br/2161704040280760; CARNEIRO, Irna Carla do Rosário Souza; http://lattes.cnpq.br/4389330944043163
Candidemia is one of the most common nosocomial infections in intensive care units. In newborns, especially premature very low birth weight (1500 g <) and extremely low birth weight (1000g <) with candidemia is an important cause of morbidity and mortality. This study aimed to evaluate the risk factors for candidemia-related mortality, set the overall mortality and mortality attributed to candidemia in neonates hospitalized in a referral hospital maternal and child health in northern Brazil during the observation period January 2008 to December 2010. In order retrospective study was conducted nested case-control study for risk factors associated with death and case-control analysis of mortality attributed to, by reviewing the microbiology and corresponding clinical records of neonates with a confirmed diagnosis of candidemia by blood culture. The Blood Stream Infection by Candida spp occurred in 34 neonates, of which about 58.8% with weight equal to or less than 1,500 g and 41.2% over 1500 g. Gestational age was equal to or below 32 weeks in 38.2% of newborns and approximately 61.8% over 32 weeks. Candida albicans was identified in 9 patients (26.5%), Candida parapsilosis in 9 patients (26.5%), Candida glabrata in one patient (2.9%) and 15 patients (44.1%) there was no identifying the species of Candida. As a risk factor associated with lethality venous dissection was present in 8 patients (23.5%) p = 0.0331. Patients with fungemia had a chance of approximately 12 times more likely to evolve to death compared to controls without fungemia. Mortality attributed to fungemia was 26.4% and overall mortality for candidemia was 52.9%. The data showed that the venous dissection was a significant risk factor for mortality in neonates with candidemia. Other risk factors were not associated with mortality. The occurrence of fungemia significantly increases the chance of a premature newborn hospitalized in the intensive care unit death evolve independent of any other clinical variable.
Acesso aberto (Open Access)
Tendências epidemiológicas em nascimentos prematuros moderados a tardios na Região Norte do Brasil
(Universidade Federal do Pará, 2019-03-29) RIBEIRO, Silvia Carolinne Pereira; GOMES, Bruno Duarte; http://lattes.cnpq.br/4932238030330851; PEREIRA JÚNIOR, Antônio; http://lattes.cnpq.br/1402289786010170
Premature birth is characterized as occurring before 37 weeks of gestation or less than 259 days from the first day of last menstruation. Brazil is among the 10 countries with the highest rate of preterm birth, which approximately 10% are preterm birth. The north region of Brazil has one of the highest rates of preterm birth in the country. Prematurity is a public health problem that can lead to problems in all systems, as well as sensory and cognitive disorders. The objective of this study was to analyze the epidemiological trends in moderate to late preterm deliveries in the North Region of Brazil. This is an ecological study of the time series of births recorded in the SINASC for residents of the North Region of Brazil between 2011 and 2016. A total of 3,549,525 births were analyzed, of which 433,907 (12.22%) were preterm birth, and the polynomial regression model was used to analyze trends in preterm births: <37 (y = -9.6 + 36.19x - 21.43x² + 6.01x³ - 0.81x4 + 0.04x5); 32 to <37 (y = -9.5 + 34.18x - 20.81x² + 6.01x³ - 0.83x4 + 0.04x5). The analysis of trends revealed a 36.19% increase in preterm births per year (r² = 1, p = <0.05) and moderate to late prematurity, from 32 to <37 weeks, increased by 34.18% (r² = 1, p <0.05). It was observed that there was an increase in the tendency of prematurity in the north region of Brazil, especially moderate to late prematurity (from 32 to <37 weeks), and greater attention is needed to prevent them, since prematurity is the largest cause of mortality in the first month of life and add considerable costs to the public coffers.