Verena Maria Mendes de Souza

Molecular identification and typing of Mycobacterium massiliense isolated from postsurgical infections in Brazil

OBJECTIVE One hundred thirty-one cases of postsurgical infections were reported in Southern Region of Brazil between August 2007 and January 2008. Thirty-nine (29.8%) cases were studied; this report describes epidemiological findings, species identification, antimicrobial susceptibility and clonal diversity of rapidly growing mycobacteria isolated in this outbreak. METHODS All 39 isolates were analyzed by Ziehl-Nielsen stained smear, bacterial culture and submitted to rpoB partial gene sequencing for identification. The isolates were also evaluated for their susceptibility to amikacin, cefoxitin, clarithromycin, ciprofloxacin, doxycycline, tobramycin and sulfamethoxazole. RESULTS Thirty-six isolates out of the confirmed cases were identified as Mycobacterium massiliense and the remaining three were identified as Mycobacterium abscessus, Mycobacterium chelonae and Mycobacterium fortuitum. All M. massiliense isolates were susceptible to amikacin (MIC90 = 8 µg/mL) and clarithromycin (MIC90 = 0.25 µg/mL) but resistant to cefoxitin, ciprofloxacin, doxycycline, tobramycin and sulfamethoxazole. Molecular analysis by pulsed-field gel electrophoresis clustered all 36 M. massiliense isolates and showed the same pattern (BRA 100) observed in three other outbreaks previously reported in Brazil. CONCLUSIONS These findings suggest a common source of infection for all patients and reinforce the hypotheses of spread of M. massiliense BRA100 in Brazilian hospital surgical environment in recent years.

Years of potential life lost and hospitalization costs associated with leptospirosis in Brazil

OBJECTIVE To estimate costs of hospitalization and years of potential life lost associated with leptospirosis. METHODS Databases of the Brazilian Ministry of Healths information system were used to carry out probabilistic linkage of cases and hospitalizations leading to death by leptospirosis in 2007. Within the Information System for Notifiable Diseases, confirmed cases were subdivided into hospitalization and death. These were then linked to the Hospital Information System (records with primary diagnosis) and the Mortality Information System (underlying cause of death A27.0, A27.8, and A27.9) databases. The partial cost of hospitalization, deaths by disease, and years of potential life and work lost, were estimated. RESULTS Most hospitalizations leading to death occurred among males aged 18-49 years, of white ethnicity, living in urban areas, and with incomplete elementary education. Years of potential life lost amounted to 6,490, 75% of which were in the 20-49 years age group. When adjusted for the population, this loss represented 15 days of life/thousand persons. The ratio of years of potential life lost to number of deaths was on average 30 years per death. The estimated financial impact amounted to R

Anos potenciais de vida perdidos e custos hospitalares da leptospirose no Brasil

22.9 million in non-earned wages. Hospitalization costs totaled R

Risk Factors for Mycobacterium abscessus subsp. bolletii infection after laparoscopic surgery during an outbreak in Brazil.

831.5 thousand. Estimated days of wages lost per admission period (median: 6 days) amounted to R

Años potenciales de vida perdidos y costos hospitalarios de la leptospirosis en Brasil

103.0 thousand. CONCLUSIONS There was a high social cost in terms of years of potential life lost and partial hospital costs associated with leptospirosis when compared to the possibility of early treatment or prevention of infection, both of which could minimize the impact of the disease on the Brazilian population.OBJETIVO: Estimar los costos asociados a la hospitalizacion y los anos potenciales de vida perdidos debido a la leptospirosis. METODOS: Se utilizaron los bancos de datos de sistemas de informacion en salud del Ministerio de la Salud para la conexion probabilistica de los casos e internaciones que evolucionaron a obito por leptospirosis en 2007. En el Sistema de Informacion de Agravios de Notificacion los casos confirmados fueron subdivididos en internacion y obito, siendo relacionados con las siguientes bases: Sistemas de Informaciones Hospitalarias (registros con diagnostico principal) y Sistemas de Informaciones sobre Mortalidad (causa basica del obito, A27.0, A27.8 y A27.9). Se estimaron los costos parciales de internacion, los obitos por la enfermedad, los anos potenciales de vida y de trabajo perdidos. RESULTADOS: Las caracteristicas de la mayoria de las internaciones que evolucionaron para obito eran: sexo masculino, entre 18 y 49 anos, raza blanca, zona urbana y educacion primaria incompleta. Fueron 6.490 anos potenciales de vida perdidos, siendo 75% del grupo de edad de 20 a 49 anos. Al realizar ajuste en la poblacion, la perdida fue de 15 dias de vida/1.000 habitantes. La proporcion de anos potenciales vida perdidos por el numero de obitos fue en promedio de 30 anos perdidos para cada obito. El impacto financiero estimado fue equivalente a R

Avaliação do conhecimento, atitudes e práticas sobre dengue no Município de Pedro Canário, Estado do Espírito Santo, Brasil, 2009: um perfil ainda atual

22,9 millones en salarios no ganados. Los costos hospitalarios duelen de R

Avaliação do Sistema Nacional de Vigilância Epidemiológica da Leptospirose - Brasil, 2007.

831,5 mil. Considerando los dias de salario perdidos por periodo de internacion (mediana: 6 dias) hubo perdida de R

Assessment of the knowledge, attitudes and practices towards dengue in the Municipality of Pedro Canário, Espírito Santo State, Brazil, 2009: an updated profile

103,0 mil. CONCLUSIONES: Hubo elevado costo social en termino de anos potenciales de vida perdidos y gasto hospitalario parcial con leptospirosis cuando se compara con el posible tratamiento precoz o al no padecimiento de la enfermedad, lo que podria haber minimizado el impacto de esta enfermedad en la poblacion brasilena.

Evaluación del conocimiento, actitudes y prácticas sobre dengue en el Municipio de Pedro Canário, Estado de Espírito Santo, Brasil, 2009: un perfil todavía actual

OBJECTIVE To estimate costs of hospitalization and years of potential life lost associated with leptospirosis. METHODS Databases of the Brazilian Ministry of Healths information system were used to carry out probabilistic linkage of cases and hospitalizations leading to death by leptospirosis in 2007. Within the Information System for Notifiable Diseases, confirmed cases were subdivided into hospitalization and death. These were then linked to the Hospital Information System (records with primary diagnosis) and the Mortality Information System (underlying cause of death A27.0, A27.8, and A27.9) databases. The partial cost of hospitalization, deaths by disease, and years of potential life and work lost, were estimated. RESULTS Most hospitalizations leading to death occurred among males aged 18-49 years, of white ethnicity, living in urban areas, and with incomplete elementary education. Years of potential life lost amounted to 6,490, 75% of which were in the 20-49 years age group. When adjusted for the population, this loss represented 15 days of life/thousand persons. The ratio of years of potential life lost to number of deaths was on average 30 years per death. The estimated financial impact amounted to R

Avaliação do conhecimento, atitudes e práticas sobre dengue no Município de Pedro Canário, Estado do Espírito Santo, Brasil, 2009: um perfil ainda atual Assessment of the knowledge, attitudes and practices towards dengue in the Municipality of Pedro Canário, Espírito Santo State, Brazil, 2009: an updated profile Evaluación del conocimiento, actitudes y prácticas sobre dengue en el Municipio de Pedro Canário, Estado de Espírito Santo, Brasil, 2009: un perfil todavía actual

22.9 million in non-earned wages. Hospitalization costs totaled R