The aim of this study was to evaluate the impact of a bundle called FAST HUG in ventilator-associated pneumonia, weigh the healthcare costs of ventilator-associated pneumonia patients in the intensive care unit, and hospital mortality due to ventilator-associated pneumonia. The study was performed in a private hospital that has an 8-bed intensive care unit. It was divided into two phases: before implementing FAST HUG, from August 2011 to August 2012 and after the implementation of FAST HUG, from September 2012 to December 2013. An individual form for each patient in the study was filled out by using information taken electronically from the hospital medical records. The following data was obtained from each patient: age, gender, reason for hospitalization, use of three or more antibiotics, length of stay, intubation time, and outcome. After the implementation of FAST HUG, there was an observable decrease in the occurrence of ventilator-associated pneumonia (p<0.01), as well as a reduction in mortality rates (p<0.01). In addition, the intervention resulted in a significant reduction in intensive care unit hospital costs (p<0.05). The implementation of FAST HUG reduced the number of ventilator-associated pneumonia cases. Thus, decreasing costs, reducing mortality rates and length of stay, which therefore resulted in an improvement to the overall quality of care.

Cryptococcosis, a systemic disease caused by the fungus Cryptococcus neoformans/ Cryptococcus gattii is more severe in immunocompromised individuals. This study aimed to analyze the epidemiology of the disease, the molecular characteristics and the antifungal susceptibility of C. neoformans isolated from patients treated in a Brazilian university hospital. This retrospective study was conducted in the Clinical Hospital, Federal University of Uberlândia, and evaluated cases of cryptococcosis and strains of C. neoformans isolated from 2004 to 2013. We evaluated 41 patients, 85% of whom were diagnosed with AIDS. The fungus was isolated from the cerebrospinal fluid (CSF) of 21 patients (51%); 19.5% had fungemia and in 24% the agent was isolated from the CSF and blood, concurrently. Meningoencephalitis was the most frequent (75%) manifestation of infection. Despite adequate treatment, the mortality of the disease was 58.5%. Most isolates (97.5%) presented the VNI genotype (serotype A, var. grubii) and one isolate was genotyped as C. gattii (VGI); all the isolates were determined as mating type MATa and showed susceptibility to the tested antifungals (fluconazole, voriconazole, amphotericin B and 5-flucytosine). Although AIDS detection rates remain stable, opportunistic infections such as cryptococcosis remain as major causes of morbidity and mortality in these patients.

Background: This study aims to investigate the occurrence of vulvovaginal infections, to describe and to relate the hygiene habits of women who were treated at the Units of Primary Attention to Family Health in a municipality in the interior of Brazil. Methods: This was a cross-sectional study that was carried out in two Primary Health Care Units of the Family of Uberlândia, Minas Gerais, Brazil. The population sample consisted of 100 women who underwent gynecological consultation in the health units. Data were collected through interviews and by the analysis of medical records. Results were reported according to laboratory reports. Results: The participants’ ages ranged from 18 to 45 years, with a median of 36 years. Thirty women (30%) presented alterations in the microbiota from a Pap smear, where bacterial vaginosis (diagnosed with Amsel criteria) was the predominant microorganism (83.3%). More than half of the women in the study who had vulvovaginitis wore cotton panties (70%, p = 0.651) and tight jeans/pants (83.3%, p = 0.010). The habit of depilating the genital area was reported by all the women, with the razor blade being the most commonly used tool (68%; p = 0.196). Conclusion: Bacterial vaginosis was the most commonly reported infection in the cytological exams. Care with genitalia and genital hygiene habits may be associated with the occurrence of vulvovaginitis.

The colonization of the oral cavity is a prerequisite to the development of oropharyngeal candidiasis. Aims: The aims of this study were: to evaluate colonization and quantify Candida spp. in the oral cavity; to determine the predisposing factors for colonization; and to correlate the levels of CD4+ cells and viral load with the yeast count of colony forming units per milliliter (CFU/mL) in HIV-positive individuals treated at a University Hospital. Saliva samples were collected from 147 HIV patients and were plated on Sabouraud Dextrose Agar (SDA) and chromogenic agar, and incubated at 30 ºC for 72 h. Colonies with similar morphology in both media were counted and the result expressed in CFU/mL. Results: Of the 147 HIV patients, 89 had positive cultures for Candida spp., with a total of 111 isolates, of which C. albicans was the most frequent species (67.6%), and the mean of colonies counted was 8.8 × 10³ CFU/mL. The main predisposing factors for oral colonization by Candida spp. were the use of antibiotics and oral prostheses. The use of reverse transcriptase inhibitors appears to have a greater protective effect for colonization. A low CD4+ T lymphocyte count is associated with a higher density of yeast in the saliva of HIV patients.