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Item Epidemiologia molecular e riscos associados ao portador nasal de Staphylococcus aureus isolados de crianças de creches de Goiânia(Universidade Federal de Goiás, 2009-04-15) CARDOSO, Juliana Lamaro; KIPNIS, André; http://lattes.cnpq.br/4434965360286741; ANDRADE, Ana Lúcia Sampaio Sgambatti de; http://lattes.cnpq.br/7770363683068899Objectives: (i) to assess the prevalence of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) nasal carriage in children attending day-care centers (DCC) in the municipality of Goiânia; (ii) to determine the potential risk factors related to S. aureus carriage and MRSA; (iii) to characterize MRSA isolates circulating in DCCs using molecular typing methods. Methods: Between August and December 2005, nasal swabs were collected from children who attended 62 DCCs. Clinical and socio-demographic information associated with the acquisition of S. aureus and MRSA were obtained through questionnaires applied to parents or guardians. The swabs were processed following the standard methods for identification and isolation of S. aureus. Amplification femB gene by polymerase chain reaction (PCR) was used to confirm the specie. The presence of mecA gene was detected by PCR and the positive isolates were identified as MRSA. Susceptibility to MRSA was determined by disk diffusion method. MRSA molecular typing was performed by PFGE, MLST, spa typing and SCCmec multiplex PCR. Results: 371 (31.1%) out of the 1.192 collected swabs were positive for S. aureus and 14 (1.2%) were identified as MRSA. The factors independently associated with risks for nasal colonization by S. aureus were children higher than two years of age (OR = 1.83, 95% CI 1.27-2.65) and previous DCC attendance (OR = 1.48; 95% CI 1.01-2.16). Mother s high degree of education was a protective factor for S. aureus carriage (OR = 0.43, 95% CI 0.23-0.80). A multidrug resistant dominant MRSA lineage was identified comprising 8 out of the 14 MRSA isolates. This cluster was characterized as SCCmec type IIIA, ST239 and spa type t037 sharing 82.7% genetic similarity with the Brazilian clone. One MRSA strain was classified as SCCmec type V and ST1120. This strain showed features of CA-MRSA although it has been recovered from a healthy child who presented risk factors for HA-MRSA acquisition. The remaining MRSA strains showed a diverse genetic background. Conclusions: Children attending DCCs are often colonized with S. aureus and although the prevalence of MRSA was low, they can represent potential vectors of spread of resistant pathogens to the community. The detection of a MRSA lineage circulating within DCCs suggests a two-way flow spread of MRSA between hospitals and community.Item A VIOLÊNCIA FÍSICA INTRAFAMILIAR COMO MÉTODO EDUCATIVO PUNITIVO-DISCIPLINAR E OS SABERES DOCENTES(Universidade Federal de Goiás, 2008-10-19) Silva, Maria Aparecida Alves da; SOUZA, Ruth Catarina Cerqueira Ribeiro de; http://lattes.cnpq.br/4438908621740299This work has the goal to search the Training and Professional Teacher. The objective of research is to know the knowledge that they relate to the teachers understand and cope with situations of physical violence inflicted by their students, from the environment intrafamily. To achieve this purpose, it is important to identify where these knowledges were built. To understand the phenomenon of physical violence against children in family education and school was used as the theoretical framework developed by the research scholars of historiography theme. Some educational proposals are highlighted in the discussion, considering that they launch concepts and methods which contribute to overcoming the use of violent practices in the education of children. The discussion made on the training of teachers has focused specifically on the teachers. To understand how it is the knowledge teachers, trying to support the theories that address the needs. The empirical research done into two schools of basic education in the city of Goiania. It was used as instruments to collect data for the development focus groups, the application of questionnaires and conducting semi-structured. Through the data found, we find that the teachers surveyed recognize and know diagnose the physical violence suffered by their students, but only when it took a severe expression, immoderate. Regarding the referral given to cases of violence, two trends dominate: trying to solve or minimize the effects or the occurrence of physical violence suffered by its students, seeking rapprochement of the family and official complaint in the Regional Education and the Guardianship Councils when the violence afflicting the student is kind of sexual. According to the testimonies of teachers, the academic training hasn t contribute ,theoretically and practically, so that teachers understand and deal in the classroom with the phenomenon of physical violence suffered by their students. To address this situation in the classroom, teachers use the knowledge from their family history and socio-cultural.Item Estudo epidemiológico e molecular de portador nasal de Staphylococcus aureus e de Staphylococcus aureus meticilinaresistente em Pronto Atendimento Pediátrico e em Unidades de Terapia Intensiva Neonatal de Goiânia(Universidade Federal de Goiás, 2010-07-05) VIEIRA, Maria Aparecida da Silva; ANDRADE, Ana Lúcia Sampaio Sgambatti de; http://lattes.cnpq.br/7770363683068899Nasal carriage of Staphylococcus aureus methicillin-resistant (MRSA) is known to be a risk for subsequent infection. The MRSA carriers are an emergent and hidden reservoir in community and in the health-care environment. The aim of this investigation were to assess the prevalence and risk factors for MRSA nasal carriage in children attending emergency departments (ED) and Neonatal Intensive Care Units (NICU), and to describe the molecular features of such isolates. Methods: Nasal swabs were obtained from children less than 60 months of age attending ED, and from newborns of the four NICUs of Goiânia city, central Brazil, in 2007 and 2008. The definition of MRSA followed the CLSI criteria. Exposure variables to S. aureus and MRSA carriers were gathered through in-person interviews with mothers and hospital records. Univariate and multivariate logistic regression were performed to identify risk factors for S. aureus and MRSA carriage. Molecular typing was evaluated by pulsed field gel electrophoresis, staphylococcal cassette chromosome mec (SCCmec) typing, and multilocus sequence type (MLST). Results: A total of 2,735 children were enrolled. At the ED (n=2.034), the prevalence respectively of nasal carriages for S. aureus and MRSA were 20% (n=408) and 0.2% (n=4). Among NICUs (total of infants = 701), the prevalence of nasal carriage ranged from 0.03% to 15.7% for S. aureus and, from 0.0% to 2.0% for MRSA. At the ED, MRSA carriage was independently associated with child-care attendance in the previous 6 months (OR=10.6; p=0.045) and congenital malformation (OR=26.8; p=0.002). All nasal carriers at NICUs were from private hospitals. Only length of hospitalization was associated with MRSA nasal carriage at NICUs (p=0.023). Among four MRSA nasal carrier at ED, one harbored SCCmec type III, and three SCCmec type IV. Among four children from at the NICUs two infants harbored SCCmec type III, and two SCCmec type IV. All MRSASCCmec type III were multidrug-resistants. Strains related to Pediatric/USA800 and Brazilian MRSA clones were detected in both, ED and NICUs. One MRSA cluster related to Western Australia/USA400 was detected in ED. Conclusions: Children visiting ED, especially those reporting day-care attendance, and neonates from NICUs may play a role in spreading MRSA in healthcare settings. The study suggests cross transmission of MRSA type III and type IV between ED and hospital environments.