Elias Jose Oliveira von Dolinger

Late onset sepsis and intestinal bacterial colonization in very low birth weight infants receiving long-term parenteral nutrition

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.

Surgical site infections in primary total hip and knee replacement surgeries, hemiarthroplasties, and osteosyntheses at a Brazilian university hospital.

We report a case-control study involving 663 primary orthopedic surgeries with a 12.7% rate of surgical site infections (SSIs). The respective frequencies of superficial incisional, deep incisional, and organ/space infections were 22.2%, 44.5%, and 33.3% for total hip arthroplasties; 66.7%, 33.3%, and 0% for total knee arthroplasties; 0%, 75.0% and 25.0% for hemiarthroplasties; and 44.1%, 35.3%, and 20.6% for osteosyntheses. These rates of SSIs are higher than those reported in previous studies.

Contaminação do ar em salas cirúrgicas durante cirurgias de artroplastias total de quadril e joelho, hemiartroplastias e osteossínteses no centro cirúrgico de um hospital Brasileiro

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.