Background Central venous catheter-associated bloodstream infections (CVC-BSIs) have been associated with increased length of hospital stay, mortality, and healthcare costs, especially in intensive care units (ICUs). The aim of this study was to evaluate the incidence density of CVC-BSIs before and after implementation of the bundle in a hospital of infectious and dermatological diseases in Central Brazil. Methods A retrospective cohort study was conducted in two ICUs (adult and pediatric) between 2012 and 2015. Two periods were compared to assess the effect of the intervention in incidence density of CVC-BSIs: before and after intervention, related to the stages before and after the implementation of the bundle, respectively. Results No significant reduction was observed in the incidence density of CVC-BSIs in adult ICU (incidence rate ratio [IRR]: 0.754; 95.0% CI: 0.349 to 1.621; p-value = 0.469), despite the high bundle application rate in the postintervention period. Similarly, significant reduction in the incidence density in pediatric ICU has not been verified after implementation of the bundle (IRR: 1.148; 95.0% CI: 0.314 to 4.193; p-value = 0.834). Conclusion Not significant reduction in the incidence density of CVC-BSIs was observed after bundle implementation in ICUs, suggesting the need to review the use of process, as well as continuing education for staffs in compliance and correct application of the bundle. Further studies are needed to evaluate the effect of bundle in the reduction of incidence density of CVC-BSIs in Brazil.

ObjectiveTo assess the impact of the Haemophilus influenzae b (Hib) conjugate vaccine in reducing the incidence of meningitis among children under five years old. Methods A 'before-after' design was used to compare Hib meningitis incidence rates in the pre-vaccine (July 1995 -June 1999) and post-vaccine (July 1999 -June 2001 periods in the state of Goiás, central Brazil . Bacterial meningitis case definition was based on World Health Organization criteria. Incidence rates of S. pneumoniae and N. meningitidis were used for comparison purposes. Chi-squared and Student's t tests were used for statistical analysis. P-values below 0.05 were considered as statistically significant. Results 979 children with acute bacterial meningitis were detected throughout the entire period. The incidence rate of Hib meningitis decreased from 10.8 (x10 5 ) in the pre-vaccine period to 2.3 (x10 5 ) in the 2 nd year post vaccination, leading to a risk reduction of 78%, targeted to the 7-23 months age group (p<0.05). A total of 65 cases of Hib meningitis were prevented. An increase in S. pneumoniae meningitis was observed. Vaccine failure was detected in one child. Conclusions This study showed that mass immunization with Hib conjugate vaccine brought about an expressive decline in childhood Hib meningitis in Goiás soon after the first year. Notwithstanding, an enhancement of surveillance using high-accuracy tools is essential to: (i) detect a possible reemergence of Hib; (ii) identify vaccine failure, and (iii) monitor changes in the H. influenzae serotype profile over time.

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Introdução: O Ministério da Saúde define Acidente de Trabalho com Exposição a Material Biológico, aquele envolvendo sangue e outros fluidos orgânicos ocorridos com os trabalhadores durante o desenvolvimento de suas atividades laborais. O risco de infecção pelo vírus da imunodeficiência humana (HIV) pós-exposição ocupacional percutânea é de aproximadamente 0,3%, pelo vírus da hepatite C (HCV) é de 1,8% a 10% e pelo vírus da hepatite B (HBV) pode atingir até 40%. Objetivo: descrever o perfil epidemiológico situação vacinal e a imunidade para hepatite B dos profissionais da área da saúde que sofreram acidentes com exposição a material biológico no período de janeiro de 2006 a junho de 2015, evidenciando a realidade de um hospital público de alta complexidade e referência em doenças infectocontagiosas do Centro-Oeste. Métodos: Trata-se de um estudo epidemiológico retrospectivo, descritivo, com abordagem quantitativa. Resultados: Este estudo constatou que, entre os profissionais da área da saúde expostos a material biológico a maioria era da equipe de enfermagem e do sexo feminino. Houve mais casos por exposição percutânea, por agulha com lúmen envolvendo sangue. Verificou-se que 76,9% eram vacinados e 57% possuíam anti-HBs maior ou igual a 10UI/L. Conclusão: o estudo permitiu conhecer o perfil epidemiológico dos trabalhadores acidentados; os resultados mostraram indicadores importantes sobre exposição ocupacional a material biológico e o potencial risco de soroconversões para hepatite B.