Background
Since the novel coronavirus disease outbreak, over 179.7 million people have been infected by SARS-CoV-2 worldwide, including the population living in dengue-endemic regions, particularly Latin America and Southeast Asia, raising concern about the impact of possible co-infections.
Methods
Thirteen SARS-CoV-2/DENV co-infection cases reported in Midwestern Brazil between April and September of 2020 are described. Information was gathered from hospital medical records regarding the most relevant clinical and laboratory findings, diagnostic process, therapeutic interventions, together with clinician-assessed outcomes and follow-up.
Results
Of the 13 cases, seven patients presented Acute Undifferentiated Febrile Syndrome and six had pre-existing co-morbidities, such as diabetes, hypertension and hypopituitarism. Two patients were pregnant. The most common symptoms and clinical signs reported at first evaluation were myalgia, fever and dyspnea. In six cases, the initial diagnosis was dengue fever, which delayed the diagnosis of concomitant infections. The most frequently applied therapeutic interventions were antibiotics and analgesics. In total, four patients were hospitalized. None of them were transferred to the intensive care unit or died. Clinical improvement was verified in all patients after a maximum of 21 days.
Conclusions
The cases reported here highlight the challenges in differential diagnosis and the importance of considering concomitant infections, especially to improve clinical management and possible prevention measures. Failure to consider a SARS-CoV-2/DENV co-infection may impact both individual and community levels, especially in endemic areas.
Objective
To describe the IMPACTO-MR, a Brazilian nationwide intensive care unit
platform study focused on the impact of health care-associated infections
due to multidrug-resistant bacteria.
Methods
We described the IMPACTO-MR platform, its development, criteria for intensive
care unit selection, characterization of core data collection, objectives,
and future research projects to be held within the platform.
Results
The core data were collected using the Epimed Monitor System® and
consisted of demographic data, comorbidity data, functional status, clinical
scores, admission diagnosis and secondary diagnoses, laboratory, clinical,
and microbiological data, and organ support during intensive care unit stay,
among others. From October 2019 to December 2020, 33,983 patients from 51
intensive care units were included in the core database.
Conclusion
The IMPACTO-MR platform is a nationwide Brazilian intensive care unit
clinical database focused on researching the impact of health
care-associated infections due to multidrug-resistant bacteria. This
platform provides data for individual intensive care unit development and
research and multicenter observational and prospective trials.
Objective:
Data are scarce regarding hospital infection control committees and compliance with infection prevention and control (IPC) recommendations in Brazil, a country of continental dimensions. We assessed the main characteristics of infection control committees (ICCs) on healthcare-associated infections (HAIs) in Brazilian hospitals.
Methods:
This cross-sectional study was conducted in ICCs of public and private hospitals distributed across all Brazilian regions. Data were collected directly from the ICC staff by completing an online questionnaire and during on-site visits through face-to-face interviews.
Results:
In total, 53 Brazilian hospitals were evaluated from October 2019 to December 2020. All hospitals had implemented the IPC core components in their programs. All centers had protocols for the prevention and control of ventilator-associated pneumonia as well as bloodstream, surgical site, and catheter-associated urinary tract infections. Most hospitals (80%) had no budget specifically allocated to the IPC program; 34% of the laundry staff had received specific IPC training; and only 7.5% of hospitals reported occupational infections in healthcare workers.
Conclusions:
In this sample, most ICCs complied with the minimum requirements for IPC programs. The main limitation regarding ICCs was the lack of financial support. The findings of this survey support the development of strategic plans to improve IPCs in Brazilian hospitals.
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