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[PMID]:29505534
[Au] Autor:Wu X; Yu C; Li T; Lin L; Xu Q; Zhu Q; Ye L; Gao X
[Ad] Endereço:Department of Urology, Fujian Provincial Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou, Fujian, PR China.
[Ti] Título:Obesity was an independent risk factor for febrile infection after prostate biopsy: A 10-year single center study in South China.
[So] Source:Medicine (Baltimore);97(1):e9549, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:To detect the best antibiotic protocol for prostate biopsy and to assess the potential risk factors postbiopsy in Chinese patients.A total of 1526 patients underwent biopsy were assessed retrospectively. The effect of 3 antibiotic protocols was compared, including fluoroquinolone (FQ) monotherapy, third-generation cephalosporin combined with FQ and targeted antibiotics according to the prebiopsy rectal swab culture result. Postbiopsy infection (PBI) was defined as fever and/or active urinary tract symptoms such as dysuria or frequency with pyuria and/or leucocytosis, sepsis is defined as the presence of clinically or microbiologically documented infection in conjunction with systemic inflammatory response syndrome. The relationship between infections and clinical characteristics of patients was assessed. Data were first picked out in univariate analysis and then enter multivariate logistic regression.Thirty-three (2.2%) patients developed febrile infection. The combination antibiotic prophylaxis could significantly decrease the rate of PBI than FQ monotherapy (1.0% vs 4.0%, P = .000). The infection rate of the targeted antibiotic group was 1.1%, but there was no significant statistic difference compared with FQ alone (P = .349). Escherichia coli was the most predominant pathogen causing infection. Rectal swab revealed as high as 47.1% and 36.0% patients harbored FQ resistant and ESBL-producing organisms, respectively. In univariate analysis, overweight (BMI between 25 and 28 kg/m), obesity (BMI > 28 kg/m), diabetes were picked out as potential risk factors. Obesity remained as risk factor (OR = 12.827, 95% CI: 0.983-8.925, P = .001) while overweight and diabetes were close to significance (P = .052, .053, respectively).The combined cephalosporin with FQ prophylaxis could significantly decrease the risk of infectious complications. Obesity was an independent risk factor for PBI.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Antibioticoprofilaxia
Obesidade/complicações
Próstata/cirurgia
Prostatite/prevenção & controle
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Biópsia/efeitos adversos
Cefalosporinas/uso terapêutico
China
Fluoroquinolonas/uso terapêutico
Seres Humanos
Infecção/etiologia
Masculino
Meia-Idade
Prostatite/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Cephalosporins); 0 (Fluoroquinolones)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009549


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[PMID]:29267501
[Au] Autor:Peng HM; Wang LC; Zhai JL; Weng XS; Feng B; Wang W
[Ad] Endereço:Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
[Ti] Título:Effectiveness of preoperative decolonization with nasal povidone iodine in Chinese patients undergoing elective orthopedic surgery: a prospective cross-sectional study.
[So] Source:Braz J Med Biol Res;51(2):e6736, 2017 Dec 18.
[Is] ISSN:1414-431X
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:Staphylococcus aureus colonization in the nares of patients undergoing elective orthopedic surgery increases the potential risk of surgical site infections. Methicillin-resistant S. aureus (MRSA) has gained recognition as a pathogen that is no longer only just a hospital-acquired pathogen. Patients positive for MRSA are associated with higher rates of morbidity and mortality following infection. MRSA is commonly found in the nares, and methicillin-sensitive S. aureus (MSSA) is even more prevalent. Recently, studies have determined that screening for this pathogen prior to surgery and diminishing staphylococcal infections at the surgical site will dramatically reduce surgical site infections. A nasal mupirocin treatment is shown to significantly reduce the colonization of the pathogen. However, this treatment is expensive and is currently not available in China. Thus, in this study, we first sought to determine the prevalence of MSSA/MSRA in patients undergoing elective orthopedic surgery in northern China, and then, we treated the positive patients with a nasal povidone-iodine swab. Here, we demonstrate a successful reduction in the colonization of S. aureus. We propose that this treatment could serve as a cost-effective means of eradicating this pathogen in patients undergoing elective orthopedic surgery, which might reduce the rate of surgical site infections.
[Mh] Termos MeSH primário: Anti-Infecciosos Locais/uso terapêutico
Procedimentos Cirúrgicos Eletivos
Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos
Cavidade Nasal/microbiologia
Procedimentos Ortopédicos
Povidona-Iodo/uso terapêutico
[Mh] Termos MeSH secundário: Administração Intranasal
Adulto
Anti-Infecciosos Locais/economia
Antibioticoprofilaxia/economia
Antibioticoprofilaxia/métodos
China
Estudos Transversais
Procedimentos Cirúrgicos Eletivos/economia
Feminino
Seres Humanos
Masculino
Staphylococcus aureus Resistente à Meticilina/crescimento & desenvolvimento
Meia-Idade
Cavidade Nasal/efeitos dos fármacos
Procedimentos Ortopédicos/economia
Complicações Pós-Operatórias/prevenção & controle
Povidona-Iodo/economia
Estudos Prospectivos
Reprodutibilidade dos Testes
Infecções Estafilocócicas/prevenção & controle
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Infective Agents, Local); 85H0HZU99M (Povidone-Iodine)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE


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[PMID]:29355906
[Au] Autor:Vermeij JD; Westendorp WF; Dippel DW; van de Beek D; Nederkoorn PJ
[Ad] Endereço:Department of Neurology, Academic Medical Centre, University of Amsterdam, PO Box 22660, Amsterdam, Netherlands, 1100 DD.
[Ti] Título:Antibiotic therapy for preventing infections in people with acute stroke.
[So] Source:Cochrane Database Syst Rev;1:CD008530, 2018 01 22.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Stroke is the main cause of disability in high-income countries and ranks second as a cause of death worldwide. Infections occur frequently after stroke and may adversely affect outcome. Preventive antibiotic therapy in the acute phase of stroke may reduce the incidence of infections and improve outcome. In the previous version of this Cochrane Review, published in 2012, we found that antibiotics did reduce the risk of infection but did not reduce the number of dependent or deceased patients. However, included studies were small and heterogeneous. In 2015, two large clinical trials were published, warranting an update of this Review. OBJECTIVES: To assess the effectiveness and safety of preventive antibiotic therapy in people with ischaemic or haemorrhagic stroke. We wished to determine whether preventive antibiotic therapy in people with acute stroke:• reduces the risk of a poor functional outcome (dependency and/or death) at follow-up;• reduces the occurrence of infections in the acute phase of stroke;• reduces the occurrence of elevated body temperature (temperature ≥ 38° C) in the acute phase of stroke;• reduces length of hospital stay; or• leads to an increased rate of serious adverse events, such as anaphylactic shock, skin rash, or colonisation with antibiotic-resistant micro-organisms. SEARCH METHODS: We searched the Cochrane Stroke Group Trials Register (25 June 2017); the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 5; 25 June 2017) in the Cochrane Library; MEDLINE Ovid (1950 to 11 May 2017), and Embase Ovid (1980 to 11 May 2017). In an effort to identify further published, unpublished, and ongoing trials, we searched trials and research registers, scanned reference lists, and contacted trial authors, colleagues, and researchers in the field. SELECTION CRITERIA: Randomised controlled trials (RCTs) of preventive antibiotic therapy versus control (placebo or open control) in people with acute ischaemic or haemorrhagic stroke. DATA COLLECTION AND ANALYSIS: Two review authors independently selected articles and extracted data; we discussed and resolved discrepancies at a consensus meeting with a third review author. We contacted study authors to obtain missing data when required. An independent review author assessed risk of bias using the Cochrane 'Risk of bias' tool. We calculated risk ratios (RRs) for dichotomous outcomes, assessed heterogeneity amongst included studies, and performed subgroup analyses on study quality. MAIN RESULTS: We included eight studies involving 4488 participants. Regarding quality of evidence, trials showed differences in study population, study design, type of antibiotic, and definition of infection; however, primary outcomes among the included studies were consistent. Mortality rate in the preventive antibiotic group was not significantly different from that in the control group (373/2208 (17%) vs 360/2214 (16%); RR 1.03, 95% confidence interval (CI) 0.87 to 1.21; high-quality evidence). The number of participants with a poor functional outcome (death or dependency) in the preventive antibiotic therapy group was also not significantly different from that in the control group (1158/2168 (53%) vs 1182/2164 (55%); RR 0.99, 95% CI 0.89 to 1.10; moderate-quality evidence). However, preventive antibiotic therapy did significantly reduce the incidence of 'overall' infections in participants with acute stroke from 26% to 19% (408/2161 (19%) vs 558/2156 (26%); RR 0.71, 95% CI 0.58 to 0.88; high-quality evidence). This finding was highly significant for urinary tract infections (81/2131 (4%) vs 204/2126 (10%); RR 0.40, 95% CI 0.32 to 0.51; high-quality evidence), whereas no preventive effect for pneumonia was found (222/2131 (10%) vs 235/2126 (11%); RR 0.95, 95% CI 0.80 to 1.13; high-quality evidence). No major side effects of preventive antibiotic therapy were reported. Only two studies qualitatively assessed the occurrence of elevated body temperature; therefore, these results could not be pooled. Only one study reported length of hospital stay. AUTHORS' CONCLUSIONS: Preventive antibiotics had no effect on functional outcome or mortality, but significantly reduced the risk of 'overall' infections. This reduction was driven mainly by prevention of urinary tract infection; no effect for pneumonia was found.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Infecções Bacterianas/prevenção & controle
Acidente Vascular Cerebral/complicações
[Mh] Termos MeSH secundário: Antibioticoprofilaxia/métodos
Infecções Bacterianas/mortalidade
Isquemia Encefálica/complicações
Seres Humanos
Pneumonia/epidemiologia
Ensaios Clínicos Controlados Aleatórios como Assunto
Acidente Vascular Cerebral/mortalidade
Infecções Urinárias/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180123
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD008530.pub3


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Registro de Ensaios Clínicos
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[PMID]:29279933
[Au] Autor:Backes M; Dingemans SA; Dijkgraaf MGW; van den Berg HR; van Dijkman B; Hoogendoorn JM; Joosse P; Ritchie ED; Roerdink WH; Schots JPM; Sosef NL; Spijkerman IJB; Twigt BA; van der Veen AH; van Veen RN; Vermeulen J; Vos DI; Winkelhagen J; Goslings JC; Schepers T; WIFI Collaboration Group
[Ad] Endereço:Trauma Unit, Department of Surgery, Academic Medical Center Amsterdam, the Netherlands.
[Ti] Título:Effect of Antibiotic Prophylaxis on Surgical Site Infections Following Removal of Orthopedic Implants Used for Treatment of Foot, Ankle, and Lower Leg Fractures: A Randomized Clinical Trial.
[So] Source:JAMA;318(24):2438-2445, 2017 12 26.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Following clean (class I, not contaminated) surgical procedures, the rate of surgical site infection (SSI) should be less than approximately 2%. However, an infection rate of 12.2% has been reported following removal of orthopedic implants used for treatment of fractures below the knee. Objective: To evaluate the effect of a single dose of preoperative antibiotic prophylaxis on the incidence of SSIs following removal of orthopedic implants used for treatment of fractures below the knee. Design, Setting, and Participants: Multicenter, double-blind, randomized clinical trial including 500 patients aged 18 to 75 years with previous surgical treatment for fractures below the knee who were undergoing removal of orthopedic implants from 19 hospitals (17 teaching and 2 academic) in the Netherlands (November 2014-September 2016), with a follow-up of 6 months (final follow-up, March 28, 2017). Exclusion criteria were an active infection or fistula, antibiotic treatment, reimplantation of osteosynthesis material in the same session, allergy for cephalosporins, known kidney disease, immunosuppressant use, or pregnancy. Interventions: A single preoperative intravenous dose of 1000 mg of cefazolin (cefazolin group, n = 228) or sodium chloride (0.9%; saline group, n = 242). Main Outcomes and Measures: Primary outcome was SSI within 30 days as measured by the criteria from the US Centers for Disease Control and Prevention. Secondary outcome measures were functional outcome, health-related quality of life, and patient satisfaction. Results: Among 477 randomized patients (mean age, 44 years [SD, 15]; women, 274 [57%]; median time from orthopedic implant placement, 11 months [interquartile range, 7-16]), 470 patients completed the study. Sixty-six patients developed an SSI (14.0%): 30 patients (13.2%) in the cefazolin group vs 36 in the saline group (14.9%) (absolute risk difference, -1.7 [95% CI, -8.0 to 4.6], P = .60). Conclusions and Relevance: Among patients undergoing surgery for removal of orthopedic implants used for treatment of fractures below the knee, a single preoperative dose of intravenous cefazolin compared with saline did not reduce the risk of surgical site infection within 30 days following implant removal. Trial Registration: clinicaltrials.gov Identifier: NCT02225821.
[Mh] Termos MeSH primário: Antibacterianos/administração & dosagem
Antibioticoprofilaxia
Cefazolina/administração & dosagem
Remoção de Dispositivo/efeitos adversos
Fraturas Ósseas/cirurgia
Extremidade Inferior/lesões
Infecção da Ferida Cirúrgica/prevenção & controle
[Mh] Termos MeSH secundário: Adulto
Idoso
Método Duplo-Cego
Feminino
Seres Humanos
Incidência
Infusões Intravenosas
Análise de Intenção de Tratamento
Fixadores Internos
Masculino
Meia-Idade
Próteses e Implantes/efeitos adversos
Qualidade de Vida
Infecção da Ferida Cirúrgica/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); IHS69L0Y4T (Cefazolin)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171228
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.19343


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[PMID]:27778039
[Au] Autor:Kamal A; Kanakeshwar RB; Shyam A; Jayaramaraju D; Agraharam D; Perumal R; Rajasekaran S
[Ad] Endereço:Department of spine surgery, Ganga Hospital, 313, Mettupalayam road, Coimbatore, India.
[Ti] Título:Variation in practice preferences in management of open injuries of extremities-an international survey by SICOT research academy.
[So] Source:Int Orthop;41(1):3-11, 2017 Jan.
[Is] ISSN:1432-5195
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Open fractures are challenging injuries and there is a lot of variation in practice preferences which may reflect the wide variations in outcome in different units across the world. A survey was done amongst the international community of SICOT membership to document the practice preferences and variations. METHODS: An online questionnaire containing 23 questions which were sub-divided into three sections covering the various aspects of open injury management was sent by email to orthopaedic trauma surgeons across the world. A total of 358 responses were evaluated and presented in this manuscript. RESULTS: The SICOT study confirmed wide variation in practice protocols. About 94.7 % of orthopaedic surgeons around the world use the Gustillo Anderson scoring system for assessment of open injury and 50.6 % of surgeons prefer lavage in operation theatre. For lavage, 84.6 % of surgeons preferred normal saline and for antibiotic prophylaxis, 48.3 % used a combination of second generation cephalosporin, metronidazole and an aminoglycoside for a minimum of three to five days. In 88 % of patients, orthopaedic surgeons performed the initial debridement and 69.2 % surgeons aimed for debridement within six hours. Regarding wound management, 43.9 % units preferred and were capable of soft tissue cover within 72 hours and about 26.3 % surgeons combined definitive fixation along with plastic procedure. CONCLUSION: Our study documented wide variations in practice preferences across the world and showed that information and awareness about current guidelines and practices will help many to update themselves in terms of basic questions about open fracture care.
[Mh] Termos MeSH primário: Fraturas Expostas/terapia
Padrões de Prática Médica/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adulto
Antibioticoprofilaxia/estatística & dados numéricos
Desbridamento/estatística & dados numéricos
Feminino
Seres Humanos
Masculino
Inquéritos e Questionários
Irrigação Terapêutica/estatística & dados numéricos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1007/s00264-016-3311-3


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[PMID]:29385159
[Au] Autor:Naimi-Akbar A; Hultin M; Klinge A; Klinge B; Tranæus S; Lund B
[Ad] Endereço:Department of Oral and Maxillofacial Surgery, Karolinska University Hospital, Huddinge, Sweden.
[Ti] Título:Antibiotic prophylaxis in orthognathic surgery: A complex systematic review.
[So] Source:PLoS One;13(1):e0191161, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: In orthognathic surgery, antibiotics are prescribed to reduce the risk of postoperative infection. However, there is lack of consensus over the appropriate drug, the dose and duration of administration. The aim of this complex systematic review was to assess the effect of antibiotics on postoperative infections in orthognathic surgery. METHODS: Both systematic reviews and primary studies were assessed. Medline (OVID), The Cochrane Library (Wiley) and EMBASE (embase.com), PubMed (non-indexed articles) and Health Technology Assessment (HTA) publications were searched. The primary studies were assessed using GRADE and the systematic reviews by AMSTAR. RESULTS: Screening of abstracts yielded 6 systematic reviews and 36 primary studies warranting full text scrutiny. In total,14 primary studies were assessed for risk of bias. Assessment of the included systematic reviews identified two studies with a moderate risk of bias, due to inclusion in the meta-analyses of primary studies with a high risk of bias. Quality assessment of the primary studies disclosed one with a moderate risk of bias and one with a low risk. The former compared a single dose of antibiotic with 24 hour prophylaxis using the same antibiotic; the latter compared oral and intravenous administration of antibiotics. Given the limited number of acceptable studies, no statistical analysis was undertaken, as it was unlikely to contribute any relevant information. CONCLUSION: With respect to antibiotic prophylaxis in orthognathic surgery, most of the studies to date have been poorly conducted and reported. Thus scientific uncertainty remains as to the preferred antibiotic and the optimal duration of administration.
[Mh] Termos MeSH primário: Antibioticoprofilaxia/métodos
Procedimentos Cirúrgicos Ortognáticos/métodos
[Mh] Termos MeSH secundário: Antibacterianos/administração & dosagem
Seres Humanos
Infecção da Ferida Cirúrgica/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191161


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[PMID]:29172849
[Au] Autor:Rahmani S; Eliott D
[Ad] Endereço:a Retina Service, Department of Ophthalmology , Massachusetts Eye and Ear , Boston , MA , USA.
[Ti] Título:Postoperative Endophthalmitis: A Review of Risk Factors, Prophylaxis, Incidence, Microbiology, Treatment, and Outcomes.
[So] Source:Semin Ophthalmol;33(1):95-101, 2018.
[Is] ISSN:1744-5205
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Postoperative endophthalmitis is one of the most feared complications of intraocular surgery. The most common types of intraocular surgeries performed worldwide are cataract extraction, glaucoma drainage implants/trabeculectomy, and pars plana vitrectomy. This review will focus on the clinical features, risk factors, prophylaxis, and treatment of endophthalmitis in these three main intraocular surgeries.
[Mh] Termos MeSH primário: Antibioticoprofilaxia/métodos
Bactérias/isolamento & purificação
Endoftalmite
Procedimentos Cirúrgicos Oftalmológicos/efeitos adversos
Infecção da Ferida Cirúrgica
[Mh] Termos MeSH secundário: Antibacterianos/uso terapêutico
Endoftalmite/epidemiologia
Endoftalmite/prevenção & controle
Endoftalmite/terapia
Saúde Global
Seres Humanos
Incidência
Fatores de Risco
Infecção da Ferida Cirúrgica/epidemiologia
Infecção da Ferida Cirúrgica/prevenção & controle
Infecção da Ferida Cirúrgica/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180219
[Lr] Data última revisão:
180219
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171128
[St] Status:MEDLINE
[do] DOI:10.1080/08820538.2017.1353826


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[PMID]:27776584
[Au] Autor:Turkova A; Chappell E; Chalermpantmetagul S; Negra MD; Volokha A; Primak N; Solokha S; Rozenberg V; Kiselyova G; Yastrebova E; Miloenko M; Bashakatova N; Kanjanavanit S; Calvert J; Rojo P; Ansone S; Jourdain G; Malyuta R; Goodall R; Judd A; Thorne C
[Ad] Endereço:Medical Research Council Clinical Trials Unit at University College London (UCL), Institute of Clinical Trials & Methodology, London, UK.
[Ti] Título:Tuberculosis in HIV-infected children in Europe, Thailand and Brazil: paediatric TB-HIV EuroCoord study.
[So] Source:Int J Tuberc Lung Dis;20(11):1448-1456, 2016 Nov.
[Is] ISSN:1815-7920
[Cp] País de publicação:France
[La] Idioma:eng
[Ab] Resumo:SETTING: Centres participating in the Paediatric European Network for Treatment of AIDS (PENTA), including Thailand and Brazil. OBJECTIVE: To describe the incidence, presentation, treatment and treatment outcomes of tuberculosis (TB) in human immunodeficiency virus (HIV) infected children. DESIGN: Observational study of TB diagnosed in HIV-infected children in 2011-2013. RESULTS: Of 4265 children aged <16 years, 127 (3%) were diagnosed with TB: 6 (5%) in Western Europe, 80 (63%) in Eastern Europe, 27 (21%) in Thailand and 14 (11%) in Brazil, with estimated TB incidence rates of respectively 239, 982, 1633 and 2551 per 100 000 person-years (py). The majority (94%) had acquired HIV perinatally. The median age at TB diagnosis was 6.8 years (interquartile range 3.0-11.5). Over half (52%) had advanced/severe World Health Organization stage immunodeficiency; 67 (53%) were not on antiretroviral therapy (ART) at TB diagnosis. Preventive anti-tuberculosis treatment was given to 23% (n = 23) of 102 children diagnosed with HIV before TB. Eleven children had unfavourable TB outcomes: 4 died, 5 did not complete treatment, 1 had recurrent TB and 1 had an unknown outcome. In univariable analysis, previous diagnosis of acquired immune-deficiency syndrome, not being virologically suppressed on ART at TB diagnosis and region (Brazil) were significantly associated with unfavourable TB outcomes. CONCLUSION: Most TB cases were from countries with high TB prevalence. The majority (91%) had favourable outcomes. Universal ART and TB prophylaxis may reduce missed opportunities for TB prevention.
[Mh] Termos MeSH primário: Antibioticoprofilaxia
Coinfecção/epidemiologia
Infecções por HIV/epidemiologia
Tuberculose/epidemiologia
[Mh] Termos MeSH secundário: Terapia Antirretroviral de Alta Atividade
Antituberculosos/uso terapêutico
Índice de Massa Corporal
Brasil/epidemiologia
Criança
Pré-Escolar
Estudos de Coortes
Coinfecção/tratamento farmacológico
Coinfecção/prevenção & controle
Europa (Continente)/epidemiologia
Feminino
Seguimentos
Infecções por HIV/tratamento farmacológico
Seres Humanos
Masculino
Prevalência
Fatores de Risco
Tailândia/epidemiologia
Tuberculose/diagnóstico
Tuberculose/tratamento farmacológico
Organização Mundial da Saúde
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Antitubercular Agents)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE


  9 / 10568 MEDLINE  
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[PMID]:29240328
[Au] Autor:Turner B; Pati J; Nargund V; Claxton A; Longstaff V; Sarkar S; Green J
[Ti] Título:Ciprofloxacin Resistance: A Review of Patients in East London Undergoing Prostate Biopsy.
[So] Source:Urol Nurs;36(4):173-82, 2016 Jul-Aug.
[Is] ISSN:1053-816X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Transrectal ultrasound guided biopsy of the prostate remains the gold standard investigation to diagnose prostate cancer. Although post-biopsy complications are relatively rare, the risk of sepsis associated with the procedure means that prophylactic antibiotics are paramount. The most widely used antibiotic regimen includes a quinolone, such as ciprofloxacin. Resistance to quinolone antibiotics is rising. In this small pilot study, the incidence of quinolone resistance was 18% in our population of patients attending the prostate biopsy clinic.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Ciprofloxacino/uso terapêutico
Farmacorresistência Bacteriana
Infecções por Escherichia coli/prevenção & controle
Escherichia coli/fisiologia
Próstata/patologia
Reto/microbiologia
[Mh] Termos MeSH secundário: Antibioticoprofilaxia/métodos
Escherichia coli/isolamento & purificação
Seres Humanos
Biópsia Guiada por Imagem
Masculino
Projetos Piloto
Complicações Pós-Operatórias/prevenção & controle
Sepse/prevenção & controle
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 5E8K9I0O4U (Ciprofloxacin)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180123
[Lr] Data última revisão:
180123
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE


  10 / 10568 MEDLINE  
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[PMID]:28743248
[Au] Autor:Karo B; Krause G; Castell S; Kollan C; Hamouda O; Haas W; ClinSurv HIV Study Group
[Ad] Endereço:Department for Infectious Disease Epidemiology, Robert Koch Institute (RKI), Seestr. 10, 13353, Berlin, Germany. karob@rki.de.
[Ti] Título:Immunological recovery in tuberculosis/HIV co-infected patients on antiretroviral therapy: implication for tuberculosis preventive therapy.
[So] Source:BMC Infect Dis;17(1):517, 2017 07 25.
[Is] ISSN:1471-2334
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Understanding the immune response to combination antiretroviral therapy (cART) is essential for a clear approach to tuberculosis (TB) preventive therapy. We investigated the immunological recovery in cART-treated HIV-infected patients developing TB compared to those who remained free of TB. METHODS: We extracted data of HIV-infected patients from a multicenter cohort for the HIV clinical surveillance in Germany. No patients included in our study had TB at the beginning of the observation. Using a longitudinal mixed model, we assessed the differences in the mean change of biomarkers (CD4+ cell count, CD8+ cell count, CD4:CD8 ratio and viral load) since cART initiation in patients who remained free of TB vs. those developing TB. To detect the best-fit trajectories of the immunological biomarkers, we applied a multivariable fractional polynomials model. RESULTS: We analyzed a total of 10,671 HIV-infected patients including 139 patients who developed TB during follow-up. The highest TB incidences were observed during the first two years since cART initiation (0.32 and 0.50 per 100 person-years). In an adjusted multivariable mixed model, we found that the average change in CD4+ cell count recovery was significantly greater by 33 cells/µl in patients who remained free of TB compared with those developing TB. After the initial three months of cART, 65.6% of patients who remaining free of TB achieved CD4+ count of ≥400 cells/µl, while only 11.3% of patients developing TB reached this immunological status after the three months of cART. We found no differences in the average change of CD8+ cell count, CD4:CD8 ratio or viral load between the two-patient groups. CONCLUSION: All HIV-infected patients responded to cART. However, patients developing TB showed reduced recovery in CD4+ cell count and this might partly explain the incident TB in HIV-infected patients receiving cART. These findings reinforce the importance of adjunctive TB preventive therapy for patients with reduced recovery in CD4+ cell count.
[Mh] Termos MeSH primário: Infecções Oportunistas Relacionadas com a AIDS/imunologia
Infecções por HIV/tratamento farmacológico
Tuberculose/imunologia
[Mh] Termos MeSH secundário: Infecções Oportunistas Relacionadas com a AIDS/epidemiologia
Infecções Oportunistas Relacionadas com a AIDS/microbiologia
Adulto
Antibioticoprofilaxia
Terapia Antirretroviral de Alta Atividade/métodos
Biomarcadores
Contagem de Linfócito CD4
Linfócitos T CD8-Positivos/efeitos dos fármacos
Estudos de Coortes
Coinfecção/tratamento farmacológico
Coinfecção/epidemiologia
Feminino
Alemanha/epidemiologia
Infecções por HIV/epidemiologia
Infecções por HIV/microbiologia
Seres Humanos
Incidência
Masculino
Meia-Idade
Tuberculose/epidemiologia
Tuberculose/prevenção & controle
Tuberculose/virologia
Carga Viral
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Biomarkers)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:180120
[Lr] Data última revisão:
180120
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1186/s12879-017-2627-y



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