Nosocomial infections (NI) are increasingly recognized causes of morbidity, added hospital costs, and mortality in industrialized countries. Limited available data in developing countries suggest that NI are common and nosocomial diarrhea (ND) appears to be severe and common illness in these countries (1). The objective of this project is to establish and validate an active NI surveillance system at the Hospital Walter Cantidio in the Northeastern Brazil, and thereby determine the epidemiology, possible predisposing risk factors, clinical outcome, added hospital days and costs of ND. The first six months of this project will be used to train the infection control team and set up the NI surveillance system. After this period we shall validate the system with a thrice weekly review of all hospital records and conduct prospective surveillance of all NI and a case-control study of ND over 4 years in this hospital. The last six months of this study will be used to complete the laboratory work and analysis of the data for publication. The NI surveillance will be conducted by three trained nurses each visiting one third of the hospital wards twice a week to consult the nursing care plan book (kept on each ward) to identify high risk patients for NI and patients with ND. Once a high risk patient or a ND case has been selected his medical charts will be reviewed by the nurse to determine the presence of NI or ND, and collect data in a standardized NI form containing information about NI and ND. To study the frequency, potential etiologies and impact of ND in addition to analysis of the surveillance data, fecal specimens from 200 randomized cases of active diarrhea and 200 matched controls without diarrhea will be reviewed and demographic data and risk factors for ND extracted for comparison with diarrhea cases. This project will establish and validate an active infection surveillance program at the Walter Cantidio Hospital and will determine the epidemiology, morbidity, mortality, potential etiologies and impact of ND and its relationship with other NI.

Project Start
Project End
Budget Start
Budget End
Support Year
1
Fiscal Year
1989
Total Cost
Indirect Cost
Name
University of Virginia
Department
Type
DUNS #
001910777
City
Charlottesville
State
VA
Country
United States
Zip Code
22904
Holaday, B J (2000) Role of CD8+ T cells in endogenous interleukin-10 secretion associated with visceral leishmaniasis. Mem Inst Oswaldo Cruz 95:217-20
Holaday, B J (1999) Immunotherapy for visceral leishmaniasis: ability of factors produced during anti-leishmania responses of skin test positive adults to inhibit peripheral blood mononuclear cell activities associated with visceral leishmaniasis. Mem Inst Oswaldo Cruz 94:55-66
Silva, A C; Santos-Neto, M S; Soares, A M et al. (1998) Efficacy of a glutamine-based oral rehydration solution on the electrolyte and water absorption in a rabbit model of secretory diarrhea induced by cholera toxin. J Pediatr Gastroenterol Nutr 26:513-9
Rocha, M F; Soares, A M; Flores, C A et al. (1998) Intestinal secretory factor released by macrophages stimulated with Clostridium difficile toxin A: role of interleukin 1beta. Infect Immun 66:4910-6
Rocha, M F; Maia, M E; Bezerra, L R et al. (1997) Clostridium difficile toxin A induces the release of neutrophil chemotactic factors from rat peritoneal macrophages: role of interleukin-1beta, tumor necrosis factor alpha, and leukotrienes. Infect Immun 65:2740-6
Koopmans, M P; Goosen, E S; Lima, A A et al. (1997) Association of torovirus with acute and persistent diarrhea in children. Pediatr Infect Dis J 16:504-7
Lima, A A; Silva, T M; Gifoni, A M et al. (1997) Mucosal injury and disruption of intestinal barrier function in HIV-infected individuals with and without diarrhea and cryptosporidiosis in northeast Brazil. Am J Gastroenterol 92:1861-6
Braga, L L; Lima, A A; Sears, C L et al. (1996) Seroepidemiology of Entamoeba histolytica in a slum in northeastern Brazil. Am J Trop Med Hyg 55:693-7
Walser, B L; Lima, A A; Guerrant, R L (1996) Effects of high-dose oral vitamin A on diarrheal episodes among children with persistent diarrhea in a northeast Brazilian community. Am J Trop Med Hyg 54:582-5
Zu, S X; Li, J F; Barrett, L J et al. (1994) Seroepidemiologic study of Cryptosporidium infection in children from rural communities of Anhui, China and Fortaleza, Brazil. Am J Trop Med Hyg 51:1-10

Showing the most recent 10 out of 15 publications