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[PMID]: 28749410 [Au] Autor: Garus-Pakowska A; Górajski M; Szatko F [Ad] Endereço: Department of Hygiene and Health Promotion, Medical University of Lodz, 90-647 Lodz, Poland. anna.garus-pakowska@umed.lodz.pl. [Ti] Título: Awareness of the Risk of Exposure to Infectious Material and the Behaviors of Polish Paramedics with Respect to the Hazards from Blood-Borne Pathogens-A Nationwide Study. [So] Source: Int J Environ Res Public Health;14(8), 2017 07 27. [Is] ISSN: 1660-4601 [Cp] País de publicação: Switzerland [La] Idioma: eng [Ab] Resumo: (1) Background: To determine paramedics' frequency of contact with blood and other body fluids, as well as the analysis of knowledge of paramedics about blood-borne infections, their attitudes to patients infected with blood-borne viruses, and the post-exposure procedures implemented by paramedics; (2) Methods: An anonymous questionnaire among 190 paramedics working in various health care facilities in Poland (adjusted response rate, 76.3%); (3) Results: 78% of paramedics had contact with potentially infectious material at least several times a week. Paramedics' knowledge on transferring infection was insufficient. Paramedics with longer employment time and better professional experience suffered fewer injuries with used needles/medical tools ( = 0.079). Most frequently reported factors that prevented the use of personal protective equipment were emergency situations (19.5%), skin irritations and contact allergies (19%) and, in the case of protective gloves, reduced manual dexterity (16%). In total, 82% of paramedics were concerned about the risk of being infected with HIV, HBV or HCV as a result of performing their job. In total, 97% of paramedics behaved more carefully while caring for infected patients. In total, 90% of the paramedics never refrained from performing the specific procedures necessary to help the patient whom they knew to be infected; (4) Conclusions: Despite the paramedics' insufficient theoretical knowledge about the risk of blood-borne infections, the emphasis in the training of future paramedics should be on classes perfecting practical skills, because growing experience significantly reduces the risk of injury. [Mh] Termos MeSH primário: Pessoal Técnico de Saúde/estatística & dados numéricos Patógenos Transmitidos pelo Sangue Transmissão de Doença Infecciosa/prevenção & controle Comportamentos Relacionados com a Saúde Conhecimentos, Atitudes e Prática em Saúde Exposição Ocupacional/prevenção & controle [Mh] Termos MeSH secundário: Adulto Feminino Seres Humanos Masculino Meia-Idade Polônia Risco Inquéritos e Questionários Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180305 [Lr] Data última revisão: 180305 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170728 [St] Status: MEDLINE

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[PMID]: 29390515 [Au] Autor: Li X; He M; Wang H [Ti] Título: Application of failure mode and effect analysis in managing catheter-related blood stream infection in intensive care unit. [So] Source: Medicine (Baltimore);96(51):e9339, 2017 Dec. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: In this study, failure mode and effect analysis (FMEA), a proactive tool, was applied to reduce errors associated with the process which begins with assessment of patient and ends with treatment of complications. The aim of this study is to assess whether FMEA implementation will significantly reduce the incidence of catheter-related bloodstream infections (CRBSIs) in intensive care unit.The FMEA team was constructed. A team of 15 medical staff from different departments were recruited and trained. Their main responsibility was to analyze and score all possible processes of central venous catheterization failures. Failure modes with risk priority number (RPN) ≥100 (top 10 RPN scores) were deemed as high-priority-risks, meaning that they needed immediate corrective action. After modifications were put, the resulting RPN was compared with the previous one. A centralized nursing care system was designed.A total of 25 failure modes were identified. High-priority risks were "Unqualified medical device sterilization" (RPN, 337), "leukopenia, very low immunity" (RPN, 222), and "Poor hand hygiene Basic diseases" (RPN, 160). The corrective measures that we took allowed a decrease in the RPNs, especially for the high-priority risks. The maximum reduction was approximately 80%, as observed for the failure mode "Not creating the maximal barrier for patient." The averaged incidence of CRBSIs was reduced from 5.19% to 1.45%, with 3 months of 0 infection rate.The FMEA can effectively reduce incidence of CRBSIs, improve the security of central venous catheterization technology, decrease overall medical expenses, and improve nursing quality. [Mh] Termos MeSH primário: Bacteriemia/terapia Patógenos Transmitidos pelo Sangue/isolamento & purificação Infecções Relacionadas a Cateter/diagnóstico Infecções Relacionadas a Cateter/terapia Cateterismo Venoso Central/efeitos adversos Análise do Modo e do Efeito de Falhas na Assistência à Saúde/métodos [Mh] Termos MeSH secundário: Centros Médicos Acadêmicos Bacteriemia/diagnóstico Cateterismo Venoso Central/métodos Cuidados Críticos/métodos Infecção Hospitalar/microbiologia Infecção Hospitalar/terapia Feminino Seres Humanos Unidades de Terapia Intensiva Comunicação Interdisciplinar Masculino Equipe de Assistência ao Paciente/organização & administração Melhoria de Qualidade Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180219 [Lr] Data última revisão: 180219 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180203 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000009339

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[PMID]: 28865865 [Au] Autor: Brewer JD; Elston DM; Vidimos AT; Rizza SA; Miller SJ [Ad] Endereço: Division of Dermatologic Surgery, Mayo Clinic, Rochester, Minnesota. Electronic address: brewer.jerry@mayo.edu. [Ti] Título: Managing sharps injuries and other occupational exposures to HIV, HBV, and HCV in the dermatology office. [So] Source: J Am Acad Dermatol;77(5):946-951.e6, 2017 Nov. [Is] ISSN: 1097-6787 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Dermatologists and their staff are at risk for needlestick injuries and exposures to body fluids. Despite the availability of treatment to reduce the risk of blood-borne infection, many exposures go unreported. This paper identifies current recommendations and the specific details for response to occupational exposures to HIV, hepatitis B virus, and hepatitis C virus in the dermatology office. Issues surrounding each virus are discussed individually, and a summary step-by-step algorithm of how to proceed in the event of an occupational exposure is presented. In addition, a focused Practice Improvement Activity that is based on this paper and provides Maintenance of Certification credit has been developed. To view and participate, visit https://secure.dataharborsolutions.com/abdermorg/. [Mh] Termos MeSH primário: Patógenos Transmitidos pelo Sangue Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle Exposição Ocupacional/efeitos adversos Saúde do Trabalhador [Mh] Termos MeSH secundário: Dermatologia Infecções por HIV/transmissão Hepacivirus/isolamento & purificação Hepatite B/transmissão Vírus da Hepatite B/isolamento & purificação Hepatite C/transmissão Seres Humanos Masculino Ferimentos Penetrantes Produzidos por Agulha/epidemiologia Visita a Consultório Médico [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171102 [Lr] Data última revisão: 171102 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170904 [St] Status: MEDLINE

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[PMID]: 28689603 [Au] Autor: Hukkinen M; Mutanen A; Pakarinen MP [Ad] Endereço: Pediatric Liver and Gut Research Group, Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland; Section of Pediatric Surgery, Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland. [Ti] Título: Small bowel dilation in children with short bowel syndrome is associated with mucosal damage, bowel-derived bloodstream infections, and hepatic injury. [So] Source: Surgery;162(3):670-679, 2017 Sep. [Is] ISSN: 1532-7361 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Liver disease occurs frequently in short bowel syndrome. Whether small bowel dilation in short bowel syndrome could influence the risk of liver injury through increased bacterial translocation remains unknown. Our aim was to analyze associations between small bowel dilation, mucosal damage, bloodstream infections, and liver injury in short bowel syndrome patients. METHODS: Among short bowel syndrome children (n = 50), maximal small bowel diameter was measured in contrast series and expressed as the ratio to the height of the fifth lumbar vertebra (small bowel diameter ratio), and correlated retrospectively to fecal calprotectin and plasma citrulline-respective markers of mucosal inflammation and mass-bloodstream infections, liver biochemistry, and liver histology. RESULTS: Patients with pathologic small bowel diameter ratio >2.17 had increased fecal calprotectin and decreased citrulline (P < .04 each). Of 33 bloodstream infections observed during treatment with parenteral nutrition, 16 were caused by intestinal bacteria, cultured 15 times more frequently when small bowel diameter ratio was >2.17 (P < .001). Intestinal bloodstream infections were predicted by small bowel diameter ratio (odds ratio 1.88, P = .017), and their frequency decreased after operative tapering procedures (P = .041). Plasma bilirubin concentration, gamma-glutamyl transferase activity, and histologic grade of cholestasis correlated with small bowel diameter ratio (0.356-0.534, P < .014 each), and were greater in the presence of intestinal bloodstream infections (P < .001 for all). Bloodstream infections associated with portal inflammation, cholestasis, and fibrosis grades (P < .031 for each). In linear regression, histologic cholestasis was predicted by intestinal bloodstream infections, small bowel diameter ratio, and parenteral nutrition (ß = 0.36-1.29; P < .014 each), while portal inflammation by intestinal bloodstream infections only (ß = 0.62; P = .033). CONCLUSION: In children with short bowel syndrome, small bowel dilation correlates with mucosal damage, bloodstream infections of intestinal origin, and cholestatic liver injury. In addition to parenteral nutrition, small bowel dilation and intestinal bloodstream infections contribute to development of short bowel syndrome-associated liver disease. [Mh] Termos MeSH primário: Bacteriemia/epidemiologia Patógenos Transmitidos pelo Sangue/isolamento & purificação Colestase/epidemiologia Intestino Delgado/patologia Hepatopatias/epidemiologia Síndrome do Intestino Curto/epidemiologia [Mh] Termos MeSH secundário: Distribuição por Idade Bacteriemia/diagnóstico Criança Pré-Escolar Colestase/diagnóstico Colestase/terapia Estudos de Coortes Comorbidade Feminino Finlândia Seres Humanos Incidência Mucosa Intestinal/patologia Hepatopatias/diagnóstico Hepatopatias/terapia Masculino Valor Preditivo dos Testes Prognóstico Estudos Retrospectivos Medição de Risco Distribuição por Sexo Síndrome do Intestino Curto/diagnóstico Síndrome do Intestino Curto/terapia Estatísticas não Paramétricas [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170913 [Lr] Data última revisão: 170913 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170711 [St] Status: MEDLINE

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[PMID]: 28683000 [Au] Autor: Markkanen P; Galligan C; Quinn M [Ad] Endereço: Department of Public Health, University of Massachusetts Lowell, Lowell, Massachusetts (Drs Markkanen and Quinn); and Safe Home Care Project, University of Massachusetts Lowell, Lowell, Massachusetts (Ms Galligan). Pia Markkanen, ScD, is a research professor in the Department of Public Health at the University of Massachusetts Lowell in Lowell, Massachusetts. She is a coinvestigator on the National Institute for Occupational Safety and Health (NIOSH)-funded Safe Home Care Project and, earlier, Project SHARRP (Safe Home Care and Risk Reduction for Providers). Catherine Galligan, MSc, is a project manager and researcher for the NIOSH-funded Safe Home Care Project and, prior to that, Project SHARRP. She has written a workbook for hospitals on mercury reduction and selection of safer alternatives, articles on hazards associated with used medical sharps, and fact sheets on occupational safety and health topics. Margaret Quinn, ScD, CIH, is a professor in the Department of Public Health at the University of Massachusetts Lowell in Lowell, Massachusetts. She is the principal investigator of the NIOSH-funded Safe Home Care Project and, prior to that, Project SHARRP. She is also a member of NIOSH's National Occupational Research Agenda Healthcare and Social Assistance Council. [Ti] Título: Safety Risks Among Home Infusion Nurses and Other Home Health Care Providers. [So] Source: J Infus Nurs;40(4):215-223, 2017 Jul/Aug. [Is] ISSN: 1539-0667 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: In the United States, home health care (HHC) is a rapidly growing industry and home infusion therapy is a rapidly growing market. HHC can present substantial occupational safety and health (OSH) risks. This article summarizes major OSH risks relevant to home infusion therapy by illustrating them through real-life scenarios collected systematically using qualitative research methods by the National Institute for Occupational Safety and Health-funded research projects at the University of Massachusetts Lowell. The need for home infusion therapy will continue to grow in the future, and safety interventions to prevent or minimize OSH risks are essential. [Mh] Termos MeSH primário: Serviços de Assistência Domiciliar/normas Visitadores Domiciliares/utilização Terapia por Infusões no Domicílio/enfermagem [Mh] Termos MeSH secundário: Patógenos Transmitidos pelo Sangue Grupos Focais Terapia por Infusões no Domicílio/métodos Seres Humanos Ferimentos Penetrantes Produzidos por Agulha/prevenção & controle Papel do Profissional de Enfermagem/psicologia Exposição Ocupacional/prevenção & controle Exposição Ocupacional/normas Saúde do Trabalhador/normas Pesquisa Qualitativa Fatores de Risco Estados Unidos [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1709 [Cu] Atualização por classe: 170912 [Lr] Data última revisão: 170912 [Sb] Subgrupo de revista: N [Da] Data de entrada para processamento: 170707 [St] Status: MEDLINE [do] DOI: 10.1097/NAN.0000000000000227

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[PMID]: 28624906 [Au] Autor: Di Minno G; Navarro D; Perno CF; Canaro M; Gürtler L; Ironside JW; Eichler H; Tiede A [Ad] Endereço: Dipartimento di Medicina Clinica e Chirurgia, Regional Reference Centre for Coagulation Disorders, Federico II University, Via S. Pansini 5, 80131, Naples, Italy. diminno@unina.it. [Ti] Título: Pathogen reduction/inactivation of products for the treatment of bleeding disorders: what are the processes and what should we say to patients? [So] Source: Ann Hematol;96(8):1253-1270, 2017 Aug. [Is] ISSN: 1432-0584 [Cp] País de publicação: Germany [La] Idioma: eng [Ab] Resumo: Patients with blood disorders (including leukaemia, platelet function disorders and coagulation factor deficiencies) or acute bleeding receive blood-derived products, such as red blood cells, platelet concentrates and plasma-derived products. Although the risk of pathogen contamination of blood products has fallen considerably over the past three decades, contamination is still a topic of concern. In order to counsel patients and obtain informed consent before transfusion, physicians are required to keep up to date with current knowledge on residual risk of pathogen transmission and methods of pathogen removal/inactivation. Here, we describe pathogens relevant to transfusion of blood products and discuss contemporary pathogen removal/inactivation procedures, as well as the potential risks associated with these products: the risk of contamination by infectious agents varies according to blood product/region, and there is a fine line between adequate inactivation and functional impairment of the product. The cost implications of implementing pathogen inactivation technology are also considered. [Mh] Termos MeSH primário: Transtornos da Coagulação Sanguínea/terapia Segurança do Sangue/métodos Transfusão de Sangue/métodos Transtornos Hemorrágicos/terapia [Mh] Termos MeSH secundário: Segurança do Sangue/normas Patógenos Transmitidos pelo Sangue/isolamento & purificação Desinfecção/métodos Seres Humanos Medição de Risco Fatores de Risco Sepse/prevenção & controle [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170804 [Lr] Data última revisão: 170804 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170619 [St] Status: MEDLINE [do] DOI: 10.1007/s00277-017-3028-4

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[PMID]: 28408215 [Au] Autor: Barbosa A; Reiss A; Jackson B; Warren K; Paparini A; Gillespie G; Stokeld D; Irwin P; Ryan U [Ad] Endereço: School of Veterinary and Life Sciences, Murdoch University, Murdoch, Perth, WA 6150, Australia; CAPES Foundation, Ministry of Education of Brazil, Brasília, DF 70040-020, Brazil,. Electronic address: A.DuarteBarbosa@murdoch.edu.au. [Ti] Título: Prevalence, genetic diversity and potential clinical impact of blood-borne and enteric protozoan parasites in native mammals from northern Australia. [So] Source: Vet Parasitol;238:94-105, 2017 Apr 30. [Is] ISSN: 1873-2550 [Cp] País de publicação: Netherlands [La] Idioma: eng [Ab] Resumo: A molecular survey was conducted to provide baseline information on the prevalence, genetic diversity and potential clinical impacts of blood-borne and enteric protozoans in native wild mammals from the Northern Territory (NT). A total of 209 blood and 167 faecal samples were collected from four target species; the northern brown bandicoot (Isoodon macrourus), common brushtail possum (Trichosurus vulpecula), northern quoll (Dasyurus hallucatus) and brush-tailed rabbit-rat (Conilurus penicillatus). Blood samples were screened by PCR at the 18S rRNA gene for trypanosomes, piroplasms and haemogregarines, with faecal samples tested for Cryptosporidium spp. at the 18S rRNA locus, and for Giardia spp. at the glutamate dehydrogenase (gdh) and 18S rRNA loci. The potential clinical impact was investigated by associating clinical, haematological and biochemical parameters with presence or absence of infection. Overall, 22.5% (95% CI: 17.0-28.8%) of the animals tested were positive for haemoprotozoans. Trypanosomes were found in 26.6% (95% CI: 18.7-35.7%) of the bandicoots and were identified as Trypanosoma vegrandis G6, except for one unique genotype, most similar to T. vegrandis G3 (genetic distance=7%). The prevalence of trypanosomes in possums was 23.7% (95% CI: 11.4-40.2%), and the genotypes identified clustered within the T. noyesi clade. The presence of Babesia sp. and Hepatozoon sp. was confirmed in bandicoots only, both at a prevalence of 9.7% (95% CI: 2.7-9.2%). The total prevalence of intestinal protozoan parasites observed was relatively low (3%; 95% CI: 1.0-6.9%). No evidence of clinical disease associated with protozoan parasitic infection was observed, however bandicoots positive for Trypanosoma exhibited a significantly lower packed cell volume (PCV) compared to negative bandicoots (p=0.046). To the authors' knowledge, this is the first research conducted in the NT to characterise protozoan parasites in threatened native mammals using both molecular and morphological tools; and to assess the potential clinical impacts of these agents. The absence of clear signs of major morbidity in infected animals seems to exclude a direct association between infections with these agents and possible population decline events in northern Australian native mammals. However until the cause(s) of population decline are ascertained for each individual mammal species, further studies are required. The outcome of the present investigation may be used to inform wildlife conservation and zoonotic disease programs. [Mh] Termos MeSH primário: Patógenos Transmitidos pelo Sangue/classificação Eucariotos/genética Variação Genética Marsupiais/parasitologia Infecções Protozoárias em Animais/parasitologia [Mh] Termos MeSH secundário: Animais Austrália/epidemiologia Eucariotos/classificação Eucariotos/isolamento & purificação Parasitemia Phyllachorales Filogenia Infecções Protozoárias em Animais/epidemiologia [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171030 [Lr] Data última revisão: 171030 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170415 [St] Status: MEDLINE

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[PMID]: 28381257 [Au] Autor: Konlan KD; Aarah-Bapuah M; Kombat JM; Wuffele GM [Ad] Endereço: Tamale Teaching Hospital, Tamale, Ghana. dkkonlan@yahoo.com. [Ti] Título: TOPIC: "The level of nurses' knowledge on occupational post exposure to hepatitis B infection in the Tamale metropolis, Ghana". [So] Source: BMC Health Serv Res;17(1):254, 2017 Apr 05. [Is] ISSN: 1472-6963 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: Health care workers especially nurses in developing countries are at serious risk for infection from blood-borne pathogens particularly hepatitis B virus (HBV) - because of the high prevalence of such pathogens in many poorer regions of the world. Employers are required to establish exposure-control plans that include post exposure follow-up for their employees and to comply with incident reporting requirements. This study assessed the level of knowledge and awareness of nurses in the Tamale Metropolis of Ghana on occupational post exposure measures to hepatitis B, and their risk of being infected. Hepatitis B vaccination status of nurses was also assessed. METHODS: A cross-sectional study was conducted involving 108 nurses of varied categories who were selected by simple random sampling from west and central hospitals in the Tamale Metropolis of Ghana. Data was collected using a semi-structured questionnaire. SPSS version 16 was used for the analysis of data. RESULTS: Ninety-four percent (94.4%) of the nurses considered themselves susceptible to occupational infection of HBV. About 23.4% were able to mention all the key elements of the post exposure management with 12.1% having adequate knowledge on post exposure prophylactic treatment against HBV. However, only 48 (44.4%) nurses have received hepatitis B vaccination. Thirty-six (75%) of those immunized had received three doses as required while the remaining had less than 3 doses. Some (38.9%) recap used needles before disposal and 30.2% do not decontaminate blood and body fluids before disposal. CONCLUSION: Nurses are aware of their risk of occupational exposure to hepatitis B but lack the requisite knowledge on post exposure management as well as measures that reduce the exposure. Nurses should familiarize with the principles of post exposure management as part of job orientation and on-going job training. Also, there is a need for a national policy on occupational safety and health which should include HB vaccination of health care workers as a requirement for appointment into the health service. [Mh] Termos MeSH primário: Conhecimentos, Atitudes e Prática em Saúde Hepatite B/etiologia Enfermeiras e Enfermeiros Exposição Ocupacional/prevenção & controle [Mh] Termos MeSH secundário: Adulto Patógenos Transmitidos pelo Sangue Estudos Transversais Feminino Gana Pessoal de Saúde/estatística & dados numéricos Vírus da Hepatite B/isolamento & purificação Seres Humanos Masculino Meia-Idade Saúde do Trabalhador Profilaxia Pós-Exposição Inquéritos e Questionários Vacinação Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1708 [Cu] Atualização por classe: 170822 [Lr] Data última revisão: 170822 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170407 [St] Status: MEDLINE [do] DOI: 10.1186/s12913-017-2182-7

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[PMID]: 28365193 [Au] Autor: Costa MD; Rapparini C; Schmaltz CAS; Tuyama M; Lauria LM; Saraceni V; Barroso PF [Ad] Endereço: Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Departamento de Medicina Preventiva, Rio de Janeiro, RJ, Brazil; Fundação Oswaldo Cruz, Instituto Nacional de Infectologia, Rio de Janeiro, RJ, Brazil. Electronic address: marcellus.costa@ini.fiocruz.br. [Ti] Título: Danger in the streets: exposures to bloodborne pathogens after community sharp injuries in Rio de Janeiro, Brazil. [So] Source: Braz J Infect Dis;21(3):306-311, 2017 May - Jun. [Is] ISSN: 1678-4391 [Cp] País de publicação: Brazil [La] Idioma: eng [Ab] Resumo: OBJECTIVE: Exposures to sharps injuries occurring in the community are relatively frequent. We describe characteristics of community sharp exposures reported in the city of Rio de Janeiro from 1997 to 2010. METHODS: A cross-sectional analysis of exposure reports to sharps in the community reported to a surveillance system, designed for health care workers, of the Municipal Health Department of Rio de Janeiro. The characteristics of exposed individuals analyzed included types of exposure, the circumstances of the accident, and the prophylaxis offered. RESULTS: 582 exposures were studied. Median age was 30 years and 83 (14%) involved children with less than 10 years of age. Two hundred and seventeen (37%) occurred with sharps found in the streets. The exposure was percutaneous in 515 (89%) and needles where involved in 406 (70%) of them. The sharps were present in the trash in 227 (39%) or in the environment in 167 (29%) of the reports. Professionals who work with frequent contact with domestic or urban waste were 196 (38%). The source was known in 112 (19%) of the exposures and blood was involved in 269 (46%). Only 101 (19%) of the injured subjects reported a complete course of vaccination for hepatitis B. Antiretroviral prophylaxis was prescribed for 392 (68%) of the exposed subjects. CONCLUSIONS: Sharps injuries occurring in the community are an important health problem. A great proportion would be avoided if practices on how to dispose needles and sharps used outside health units were implemented. [Mh] Termos MeSH primário: Patógenos Transmitidos pelo Sangue Ferimentos Penetrantes Produzidos por Agulha/epidemiologia [Mh] Termos MeSH secundário: Adolescente Adulto Idoso Brasil/epidemiologia Criança Estudos Transversais Feminino Seres Humanos Masculino Meia-Idade Agulhas/estatística & dados numéricos Distribuição Espacial da População Resíduos/efeitos adversos [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Waste Products) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171003 [Lr] Data última revisão: 171003 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170403 [St] Status: MEDLINE

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[PMID]: 28234349 [Au] Autor: Segers FH; Kesnerová L; Kosoy M; Engel P [Ad] Endereço: Department of Fundamental Microbiology, University of Lausanne, Lausanne, Switzerland. [Ti] Título: Genomic changes associated with the evolutionary transition of an insect gut symbiont into a blood-borne pathogen. [So] Source: ISME J;11(5):1232-1244, 2017 May. [Is] ISSN: 1751-7370 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: The genus Bartonella comprises facultative intracellular bacteria with a unique lifestyle. After transmission by blood-sucking arthropods they colonize the erythrocytes of mammalian hosts causing acute and chronic infectious diseases. Although the pathogen-host interaction is well understood, little is known about the evolutionary origin of the infection strategy manifested by Bartonella species. Here we analyzed six genomes of Bartonella apis, a honey bee gut symbiont that to date represents the closest relative of pathogenic Bartonella species. Comparative genomics revealed that B. apis encodes a large set of vertically inherited genes for amino acid and cofactor biosynthesis and nitrogen metabolism. Most pathogenic bartonellae have lost these ancestral functions, but acquired specific virulence factors and expanded a vertically inherited gene family for harvesting cofactors from the blood. However, the deeply rooted pathogen Bartonella tamiae has retained many of the ancestral genome characteristics reflecting an evolutionary intermediate state toward a host-restricted intraerythrocytic lifestyle. Our findings suggest that the ancestor of the pathogen Bartonella was a gut symbiont of insects and that the adaptation to blood-feeding insects facilitated colonization of the mammalian bloodstream. This study highlights the importance of comparative genomics among pathogens and non-pathogenic relatives to understand disease emergence within an evolutionary-ecological framework. [Mh] Termos MeSH primário: Bartonella/genética Abelhas/microbiologia Evolução Molecular Genoma Bacteriano [Mh] Termos MeSH secundário: Animais Bartonella/classificação Bartonella/patogenicidade Bartonella/fisiologia Patógenos Transmitidos pelo Sangue Trato Gastrointestinal/microbiologia Genômica Insetos/microbiologia Simbiose Fatores de Virulência/genética [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Virulence Factors) [Em] Mês de entrada: 1706 [Cu] Atualização por classe: 171116 [Lr] Data última revisão: 171116 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170225 [St] Status: MEDLINE [do] DOI: 10.1038/ismej.2016.201

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