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Impact of macrolide therapy on mortality of HIV-infected patients with community-acquired pneumonia in a tertiary teaching hospital BJID
Mello,Claudia Figueiredo; Negra,Marinella Della.
BACKGROUND: Bacterial pneumonia is one of the main causes of morbidity and mortality in patients infected by the human immunodeficiency virus (HIV). The main objective of this study was to evaluate the effect of macrolide therapy in combination with a beta-lactam based empiric regimen for inpatients with community-acquired pneumonia and HIV. METHODS: This is a retrospective cohort study of hospitalized patients. Adult patients who had received treatment with ceftriaxone or ceftriaxone plus clarithromycin were included. RESULTS: 76 patients met the inclusion criteria. Among baseline characteristics analyzed, only respiratory rate showed significant difference: patients who had received clarithromycin were more likely to have a respiratory rate > 30/min...
Tipo: Info:eu-repo/semantics/article Palavras-chave: HIV; Pneumonia; Macrolides; Mortality.
Ano: 2011 URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702011000300014
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Childhood pneumonia: clinical aspects associated with hospitalization or death BJID
Nascimento-Carvalho,Cristiana M.C.; Rocha,Heonir; Santos-Jesus,Rogério; Benguigui,Yehuda.
OBJECTIVE: To determine which available information at an Emergency Room (ER) consultation is associated with hospitalization or death among children with pneumonia. DESIGN: Prospective cohort study. SETTING: The ER of one university and one private hospital. MEASUREMENT: Using stepwise logistic regression we analyzed factors that showed a univariate association. MAIN RESULTS: Of 2,970 cases, the median age was 1.83 years (range 2 days to 14.5 yrs, mean 2.76 + 2.72 yrs); 25.8% were hospitalized and 0.8% died. Age (2-11 mos, OR 0.4 [0.2-0.6]; 12-59 mos, OR 0.2 [0.1-0.4]; <FONT FACE=Symbol>³</FONT> 5yrs, OR 0.1 [0.08-0.3]), malnutrition (OR 2.0 [1.4-2.7]), underlying chronic illness (OR 1.4 [1.1-1.8]), tachypnea (OR 1.8 [1.4-2.4]), chest...
Tipo: Info:eu-repo/semantics/article Palavras-chave: Pneumonia; Children; Clinical signs; Hospitalization; Mortality; Outpatients.
Ano: 2002 URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702002000100004
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Transitioning through AIDS epidemics - gender and temporality BJID
Pinto,Clarice Souza; Fernandes,Carlos Eurico dos Santos; Oliveira,Roberto Dias de; Matos,Vanessa Terezinha Gubert de; Castro,Ana Rita Coimbra Motta de.
ABSTRACT OBJECTIVE: To understand the evolution of AIDS over time in Mato Grosso do Sul, Brazil, using incidence, lethality, and mortality coefficients. METHODS: A descriptive epidemiological study based on time series analysis of secondary data from the Notifiable Diseases Information System reported between 1985 and 2012. RESULTS: The prevalence of AIDS was higher among men, with evidence of feminization during the first 14 years of the epidemic. There was no statistically significant sex difference in AIDS lethality. Women were 1.3 times more likely to survive than men. CONCLUSIONS: Gender differences must be considered when designing new HIV/AIDS prevention strategies.
Tipo: Info:eu-repo/semantics/other Palavras-chave: Aids; Mortality; Lethality; Incidence.
Ano: 2015 URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702015000600657
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Clinical presentation of leptospirosis: a retrospective study of 201 patients in a metropolitan city of Brazil BJID
Daher,Elizabeth F; Lima,Rafael SA; Silva Júnior,Geraldo B; Silva,Eveline C; Karbage,Nahme NN; Kataoka,Raquel S; Carvalho Júnior,Paulo C; Magalhães,Max M; Mota,Rosa MS; Libório,Alexandre B.
INTRODUCTION: leptospirosis is a zoonosis of worldwide importance. The disease is endemic in Brazil. This study was conducted to describe the clinical and laboratory presentation of leptospirosis in a metropolitan city of Brazil. METHODS: this is a retrospective study including 201 consecutive patients with leptospirosis admitted to tertiary hospitals in Fortaleza, Brazil, between 1985 and 2006. All patients had clinical and epidemiological data suggestive of leptospirosis, and positive laboratorial test for leptospirosis (microscopic agglutination test, MAT, higher than 1:800). RESULTS: a total of 201 patients were included, with mean age of 38.9 ± 15.7 years; 79.1% were male. The mean length from onset of symptoms to admission was 7 ± 3 days. The main...
Tipo: Info:eu-repo/semantics/article Palavras-chave: Leptospirosis; Clinical manifestations; Laboratory findings; Mortality.
Ano: 2010 URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702010000100002
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Factors influencing the early mortality in haematological malignancy patients with nosocomial Gram negative bacilli bacteraemia: a retrospective analysis of 154 cases BJID
Metan,Gökhan; Demiraslan,Hayati; Kaynar,Leyla Gül; Zararsız,Gökmen; Alp,Emine; Eser,Bülent.
BACKGROUND: The aim of this study is to assess the factors influencing the early mortality (7- day after index blood culture) in haematological malignancy patients with Gram negative bacilli (GNB) bacteraemia. METHODS: Infection control committee records were reviewed to identify the cases between March 2006 and June 2011. Only one bacteraemic episode per patient was included in the study. RESULTS: A total of 154 patients with GNB bacteraemia were identified. The early mortality rate was 19.5% (30 out of 154). Blood cultures revealed Enterobacteriacea in 120 patients (Escherichia coli; 86, Klebsiella spp.; 28, Enterobacter cloacea; 6) and glucose non-fermenting GNB in 34 patients (Pseudomonas aeruginosa; 15, Acinetobacter baumannii; 11, Stenotrophomonas...
Tipo: Info:eu-repo/semantics/article Palavras-chave: Haematological malignancy; Bacteraemia; Gram negative bacilli; Mortality; Extended-spectrum beta-lactamase; Intensive care unit; Multidrug resistance.
Ano: 2013 URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702013000200005
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Application of the ATLAS score for evaluating the severity of Clostridium difficile infection in teaching hospitals in Mexico BJID
Hernández-García,Raúl; Garza-González,Elvira; Miller,Mark; Arteaga-Muller,Giovanna; Galván-de los Santos,Alejandra María; Camacho-Ortiz,Adrián.
Background: For clinicians, a practical bedside tool for severity assessment and prognosis of patients with Clostridium difficileinfection is a highly desirable unmet medical need.Setting: Two general teaching hospitals in northeast Mexico.Population: Adult patients with C. difficileinfection.Methods: Prospective observational study.Results: Patients included had a median of 48 years of age, 54% of male gender and an average of 24.3 days length of hospital stay. Third generation cephalosporins were the antibiotics most commonly used prior to C. difficileinfection diagnosis. Patients diagnosed with C. difficileinfection had a median ATLAS score of 4 and 56.7% of the subjects had a score between 4 and 7 points. Patients with a score of 8 through 10 points had...
Tipo: Info:eu-repo/semantics/article Palavras-chave: Clostridium difficile; Prediction rule; Mortality.
Ano: 2015 URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702015000400399
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Factors associated with mortality in HIV patients failing antiretroviral therapy, in Salvador, Brazil BJID
Haguihara,Tatiana; Silva,Márcio da Oliveira; Rebouças,Monaliza Cardozo; Martins Netto,Eduardo; Brites,Carlos.
ABSTRACT Highly active antiretroviral therapy (HAART) has significantly improved survival of people living with HIV/Aids (PLWHA). However, poor treatment adherence to HAART and other problems, still cause therapy failure and contribute to increased morbidity and mortality of PLWHA. In this retrospective cohort study (2013-2015), we sought to evaluate the factors associated with mortality of PLWHA failing HAART in 2013, who were receiving care at a reference center for sexually transmitted diseases (STD) and HIV/AIDS. A total of 165 individuals over 18 years of age who were failing antiretroviral therapy were evaluated. In two-year follow-up, 19 (11.5%) deaths were documented. There were a significant association between mortality and report of illicit drug...
Tipo: Info:eu-repo/semantics/article Palavras-chave: Virologic failure; Mortality; HIV.
Ano: 2019 URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702019000300160
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Clinical and economic impact of generic versus brand name meropenem use in an intensive care unit in Colombia BJID
Ordóñez,Karen; Feinstein,Max M.; Reyes,Sergio; Hernández-Gómez,Cristhian; Pallares,Christian; Villegas,María V..
Abstract Background: Recent studies suggest that sustained use of generic antibiotics may be associated with clinical failure and emergence of antibacterial resistance. The present study was designed to determine the clinical outcome between the use of generic meropenem (GM) and brand-name meropenem (BNM). Additionally, this study evaluated the economic impact of GM and BNM to determine if the former represents a cost-effective alternative to the latter. Methods: Patients treated between January 2011 and May 2014 received GM while patients treated between June 2014 and March 2017 received BNM. Mortality was compared between groups. Total infection cost was defined by the cost of antimicrobial consumption, length of stay, and laboratory and imaging exams...
Tipo: Info:eu-repo/semantics/article Palavras-chave: Generic drugs; Meropenem; Mortality; Costs; Critical care; Gram negative bacteria.
Ano: 2019 URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702019000400237
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Georeferencing of deaths from sepsis in the city of São Paulo BJID
Diament,Décio; Colombari,Fernando; Cypriano,Adriana Serra; Lisboa,Luis Fernando; dos Santos,Bento Fortunato Cardoso; Cendoroglo Neto,Miguel; Serpa Neto,Ary; Silva,Eliezer.
Abstract Objective The aim of the present study was to obtain information about deaths due to sepsis in São Paulo from 2004 to 2009 and their relationship with geographical distribution. Methods Causes of death, both main and secondary, were defined according to the codes of the International Classification of Disease version 10 (ICD-10) contained in the database. Sepsis, septic shock, multiple organ failure, pneumonia, urinary tract infection, peritonitis and other intraabdominal infections, skin and soft tissue infections (including surgical wound infection) and meningitis were considered as immediate cause of death or as the condition leading to the immediate cause of death related or associated to sepsis. Results In the analyzed period, there was a...
Tipo: Info:eu-repo/semantics/article Palavras-chave: Sepsis; Mortality; Infection; Georeferencing.
Ano: 2016 URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702016000200149
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A cost-effectiveness analysis of two different antimicrobial stewardship programs BJID
Okumura,Lucas Miyake; Riveros,Bruno Salgado; Gomes-da-Silva,Monica Maria; Veroneze,Izelandia.
Abstract There is a lack of formal economic analysis to assess the efficiency of antimicrobial stewardship programs. Herein, we conducted a cost-effectiveness study to assess two different strategies of Antimicrobial Stewardship Programs. A 30-day Markov model was developed to analyze how cost-effective was a Bundled Antimicrobial Stewardship implemented in a university hospital in Brazil. Clinical data derived from a historical cohort that compared two different strategies of antimicrobial stewardship programs and had 30-day mortality as main outcome. Selected costs included: workload, cost of defined daily doses, length of stay, laboratory and imaging resources used to diagnose infections. Data were analyzed by deterministic and probabilistic sensitivity...
Tipo: Info:eu-repo/semantics/article Palavras-chave: Antimicrobial stewardship program; Cost-effectiveness; Mortality; Pharmacist.
Ano: 2016 URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702016000300006
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The epidemiology of sepsis in a Brazilian teaching hospital BJID
Kauss,IAM; Grion,Cintia MC; Cardoso,LTQ; Anami,EHT; Nunes,LB; Ferreira,GL; Matsuo,T; Bonametti,AM.
OBJECTIVES: The objective of this study was to estimate disease incidence and mortality rate of sepsis in a tertiary public hospital. METHODS: Patients admitted to the Intensive Care Unit (ICU) in 2004 and 2005 were monitored for sepsis using an observational longitudinal study design. Patients were monitored daily for diagnostic criteria of sepsis, according to ACCP/SCCM Consensus Conference criteria, until either death or hospital discharge. RESULTS: During the study, we analyzed 1,179 patients. Systemic Inflammatory Response Syndrome (SIRS) was present in 1,048 (88.9%) patients on admission, and was associated with infection in 554 (47.0%) patients. Of these, sepsis was diagnosed in 30 (2.5%) patients, while severe sepsis was diagnosed in 269 (22.8%)...
Tipo: Info:eu-repo/semantics/article Palavras-chave: Sepsis; Incidence; Mortality; Epidemiology.
Ano: 2010 URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702010000300011
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Effects of statins on the development of sepsis and organ dysfunction in hospitalized older patients in China BJID
Gui,Qifeng; Yang,Yunmei; Zhang,Jiajia.
ABSTRACT This study aimed to evaluate the protective role of statins on the development of sepsis and infection-related organ dysfunction and mortality in a hospitalized older Chinese population with bacterial infections. In this retrospective cohort study, 257 older patients with bacterial infection were divided into two groups: a statin group, those who had received statin therapy for ≥1 month before admission and continued receiving statin during hospitalization; and a non-statin group, those who had never received statin or used statin for <1 month prior to admission. A multivariate logistic regression analysis was performed to identify risk and protective factors for severe sepsis. A significantly lower incidence of organ dysfunction was found in...
Tipo: Info:eu-repo/semantics/article Palavras-chave: Mortality; Organ dysfunction; Older adults; Sepsis; Statins.
Ano: 2017 URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702017000300255
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The organization of Hospital Infection Control Committees and their importance in Brazil BJID
El Far,Fabiane; Marino,Cristiane G. J.; Medeiros,Eduardo Alexandrino Servolo.
The importance of Hospital Infection Control Committees (HICC) increases every year due to the emergence of multiresistant bacterial strains, hospital outbreaks, and other factors that cause HI. This demonstrates the fragility of the quality of hospital and medical care. Having a well-organized HICC benefits hospitals by improving quality, lowering costs and, most important, reducing patient morbidity and mortality. This review records the history of the development of HICCs, their present organizational structure, and offers recommendations for the best methods of infection surveillance.
Tipo: Info:eu-repo/semantics/article Palavras-chave: Hospital infection; Prevention; Committee; Control; Costs; Mortality; Surveillance; Quality.
Ano: 2001 URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702001000600001
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Bacteremic pneumococcal pneumonia: serotype distribution, antimicrobial susceptibility, severity scores, risk factors, and mortality in a single center in Chile BJID
Fica,Alberto; Bunster,Nicolás; Aliaga,Felipe; Olivares,Felipe; Porte,Lorena; Braun,Stephanie; Dabanch,Jeannette; Hormázabal,Juan Carlos; Hernández,Antonio; Benavides,María Guacolda.
AIMS:Bacteremic pneumococcal pneumonia (BPP) is a severe condition. To evaluate seasonal distribution, mortality, serotype frequencies, antimicrobial susceptibility, and different severity scores among patients with BPP.PATIENTS AND METHODS:Patients were identified by laboratory data and restricted to adulthood. Standard methods were used for serotyping and antimicrobial susceptibility. Risk factors were analyzed by univariate and multivariate methods. Severity scores (APACHE II, CURB-65 and CAP PIRO) were compared using ROC curves.RESULTS:Sixty events of community-acquired BPP occurred between 2005 and 2010. A seasonal pattern was detected. Mean age was 72.1 years old (81.4% >60 years). All had a predisposing factor. Previous influenza (3.3%) or...
Tipo: Info:eu-repo/semantics/article Palavras-chave: Streptococcus pneumoniae; Bacteremia; Serotyping; Microbial drug resistance; Risk factors; Mortality; Elderly; CURB-65; APACHE II; PIRO.
Ano: 2014 URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702014000200115
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Nosocomial infections in brazilian pediatric patients: using a decision tree to identify high mortality groups BJID
Lopes,Julia M.M.; Goulart,Eugenio M.A.; Siqueira,Arminda L.; Fonseca,Inara K.; Brito,Marcus V.S. de; Starling,Carlos E.F..
Nosocomial infections (NI) are frequent events with potentially lethal outcomes. We identified predictive factors for mortality related to NI and developed an algorithm for predicting that risk in order to improve hospital epidemiology and healthcare quality programs. We made a prospective cohort NI surveillance of all acute-care patients according to the National Nosocomial Infections Surveillance System guidelines since 1992, applying the Centers for Disease Control and Prevention 1988 definitions adapted to a Brazilian pediatric hospital. Thirty-eight deaths considered to be related to NI were analyzed as the outcome variable for 754 patients with NI, whose survival time was taken into consideration. The predictive factors for mortality related to NI (p...
Tipo: Info:eu-repo/semantics/article Palavras-chave: Epidemiology; Healthcare quality; Mortality; Nosocomial infection; Pediatric hospital.
Ano: 2009 URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702009000200008
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Trends and characteristics of AIDS mortality in the Rio de Janeiro city after the introduction of highly active antiretroviral therapy BJID
Saraceni,Valéria; Cruz,Marly Marques da; Lauria,Lilian de Mello; Durovni,Betina.
We examined the characteristics of AIDS mortality in Rio de Janeiro city from 1995 to 2003. During this period, highly active antiretroviral therapy with protease inhibitors was made available, and it changed the pattern of the epidemics. There was a 47.5% reduction in the number of AIDS deaths within the period, with an increase in the proportion of women among the deceased; their schooling was lower than that of the men, similar to the trends of the national-level epidemics. The main place of death changed from university hospitals to emergency rooms. The proportion of cases reported to the National Diseases Surveillance System (SINAN) reported only through the death certificate remained high. Although there is free distribution of antiretrovirals by the...
Tipo: Info:eu-repo/semantics/article Palavras-chave: AIDS; Mortality; Antiretrovirals.
Ano: 2005 URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702005000300003
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Is nosocomial Escherichia coli bacteremia a predictive risk factor for mortality? BJID
Tuon,Felipe F.; Rocha,Jaime L.; Guadagnin,Fernanda A.; Alves,Márcia S..
The objective of this study was to determine risk factors associated with mortality in patients with nosocomial Escherichia coli bacteremia from January 2009 to January 2011. In a retrospective study the medical records of 88 patients over 18 years with nosocomial bacteremia caused by E. coli were analyzed. In univariate analysis several risk factors, including chronic renal failure, altered mental status, leukocytosis, and higher Charlson index of comorbidities were associated with mortality. In multivariate analysis only altered mental status remained independently associated with mortality. Mental confusion can be a risk factor for mortality in patients with E. coli bacteremia.
Tipo: Info:eu-repo/semantics/report Palavras-chave: Nosocomial bacteremia; Escherichia coli; Mortality; Antibiotic therapy.
Ano: 2014 URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702014000100092
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Comparison of clinical characteristics between healthcare-associated pneumonia and community-acquired pneumonia in patients admitted to secondary hospitals BJID
Lee,Jong Hoo; Kim,Yee Hyung.
BACKGROUND: Since healthcare-associated pneumonia (HCAP) is heterogeneous, clinical characteristics and outcomes are different from region to region. There can also be differences between HCAP patients hospitalized in secondary or tertiary hospitals. This study aimed to evaluate the clinical characteristics of HCAP patients admitted into secondary community hospitals. METHODS: This was a retrospective study conducted in patients with HCAP or community-acquired pneumonia (CAP) hospitalized in two secondary hospitals between March 2009 and January 2011. RESULTS: Of a total of 303 patients, 96 (31.7%) had HCAP. 42 patients (43.7%) resided in a nursing home or long-term care facility, 36 (37.5%) were hospitalized in an acute care hospital for &gt; 2 days...
Tipo: Info:eu-repo/semantics/article Palavras-chave: Health care; Pneumonia; Antibiotics; Mortality; Resistance.
Ano: 2012 URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702012000400002
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Risk factors for mortality in patients with ventilator-associated pneumonia caused by carbapenem-resistant Enterobacteriaceae BJID
Tuon,Felipe F.; Graf,Maria Esther; Merlini,Alexandre; Rocha,Jaime L.; Stallbaum,Suellen; Arend,Lavinia N.; Pecoit-Filho,Roberto.
Abstract Background: The ideal therapeutic option for ventilator associated pneumonia caused by carbapenem-resistant Enterobacteriaceae is not defined. The aim of this study was to assess mortality-associated risk factors in patients with VAP by CRE and determine the outcome of several treatment options. Methods: This was a retrospective study performed in two tertiary hospitals involving patients with VAP caused by CRE between January 2010 and August 2014. The outcomes were mortality within 30 days of VAP diagnosis and overall mortality during hospital admission. Risk factors for mortality were assessed by comparing variables of survivors and non-survivors. Results: One hundred and twelve patients with CRE-VAP were included, 73 (65%) male, median age...
Tipo: Info:eu-repo/semantics/article Palavras-chave: Carbapenemase-producing Klebsiella pneumoniae; Ventilator-associated pneumonia; Risk factors; Mortality; Treatment.
Ano: 2017 URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702017000100001
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Risk factors for mortality in burn children BJID
Rosanova,Maria Teresa; Stamboulian,Daniel; Lede,Roberto.
Studies about risk factors for mortality in burn children are scarce. We conducted this study to evaluate the risk factors for mortality in pediatric burn patients. We included 110 patients. Mean age was 31.5 months (range: 1 to 204). The burn surface was between 1% and 95%(median 27%) Type of burn was: A or superfitial in 39 patients (36%), AB or intermediate in 19 (17%), and B or full thickness in 52 (47%). Inhalatory injury was present in 52 patients (47%). Invasive procedures were: venous catheter, 90 patients (82%), arterial catheter, 83patients (75.5%), urinary catheter, 86 patients (78%), and mechanical ventilation, 75 patients (68%). In 84 patients, 128 infections were diagnosed. in 53 cases (48%). Multiresistant Pseudomonas aeruginosa and...
Tipo: Info:eu-repo/semantics/article Palavras-chave: Burns; Mortality; Children.
Ano: 2014 URL: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1413-86702014000200144
Registros recuperados: 306
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