Escherichia coli e Klebsiella spp. ESBL em Hospital Universitário, na cidade de Manaus - AM / Escherichia coli and Klebsiella spp ESBL at University Hospital, in Manaus / Escherichia coli y Klebsiella spp ESBL en Hospital Universitario, en Manaus

Justificativa e Objetivos: Bactérias produtoras de betalactamase de espectro ampliado (ESBL) são crescentes, sobretudo, pelo uso rotineiro de antibióticos. Causam principalmente, infecções urinárias e de feridas operatórias e, caracterizam-se pela resistência às cefalosporinas de terceira geração, aztreonam e associação de cefalosporinas com ácido clavulânico. Este estudo teve como objetivo conhecer a frequência de Escherichia coli ESBL e Klebsiella spp. ESBL através da análise fenotípica. Métodos: Teste de sensibilidade in vitro por aproximação de discos (CLSI), de bactérias isoladas de meios biológicos dos pacientes atendidos no HUGV entre 2017 e 2018. Resultados: 34,66% eram Escherichia coli ESBL e 46,80% Klebsiella spp. ESBL, totalizando 39,34% de amostras ESBL. Dos meios biológicos predominaram ESBL na: urina (56,25%) e feridas cirúrgicas (22,91%). Clínicas com maior ocorrência de ESBL: médica e cirúrgica. Conclusão: Os índices de ESBL no HUGV estão próximos ou até mais altos do que em algumas regiões do país. Consoante a literatura revisada, predomina a Escherichia coli nos isolados e há mais Klebisella spp. ESBL do que Escherichia coli ESBL.(AU)

Background and Objectives: Extended-spectrum beta-lactamase (ESBL) producing bacteria are increasingly present, above all, by the routine use of antibiotics. They mainly cause urinary and operative wound infections and are characterized by resistance to third- -generation cephalosporins, aztreonam and the association of cephalosporins with clavulanic acid. This study has objective to know the frequency of ESBL Escherichia coli and Klebsiella spp., through phenotype. Methods: In vitro sensitivity test by disk approximation (CLSI) of the bacteria isolated from biological materials of patients attended in HUGV between 2017 and 2018 and analysis in Microsoft Office Excel software, v. 2016, for calculation of frequencies. Results: 34.66% were Escherichia coli ESBL and 46.80% Klebsiella spp. ESBL totaling 39.34% ESBL samples. Of the biological media ESBL were predominant in: urine (56.25%) and surgical wounds (22.91%). Clinics with greater occurrence of ESBL: medical and surgical. Conclusion: The ESBL indices in the HUGV are close or even higher than in some regions of the country. According to the revised literature, Escherichia coli predominates in isolated and there is more Klebisella spp. ESBL than Escherichia coli ESBL.(AU)

Justificación y objetivos: Las bacterias productoras de betalactamasa de espectro extendido (ESBL) están cada vez más presentes, sobre todo, por el uso rutinario de antibióticos, causan principalmente infecciones urinarias y de heridas operativas y se caracterizan por la resistencia a las cefalosporinas de tercera generación, aztreonam y asociación de cefalosporinas. Este estudio tiene como objetivo determinar la prevalencia de Escherichia coli y Klebsiella sp. ESBL, a través de análisis fenotípico. Métodos: Prueba de sensibilidad in vitro por aproximación de discos (CLSI) de bacterias aisladas de medios biológicos de los pacientes atendidos en el HUGV entre 2017 y 2018, y análisis en el software Microsoft Office Excel, v. 2016, para cálculos de frecuencia. Resultados: 34,66% eran Escherichia coli ESBL y 46,80% Klebsiella spp. ESBL, totalizando 39,34% de muestras ESBL. De los medios biológicos predominaron ESBL en: orina (56,25%) y heridas quirúrgicas (22,91%). Clínicas con mayor ocurrencia de ESBL: médica y quirúrgica. Conclusión: Los índices de ESBL en HUGV son cercanos o incluso más altos que en algunas regiones del país. Según la literatura revisada, Escherichia coli predomina en los aislados y hay más Klebisella spp. ESBL que Escherichia coli ESBL.(AU)

Epidemiological and TNFα polymorphism evaluation in patients with cryptococcal meningitis treated at a referral hospital in North Brazil

Abstract INTRODUCTION: The present study evaluated the epidemiology of cryptococcal meningitis and TNFα gene polymorphisms in patients at a reference hospital in northern Brazil. METHODS: Samples from 25 patients infected with Cryptococcus spp. were collected to confirm the infection and to analyze the TNFα gene polymorphisms. RESULTS: Cryptococcus neoformans was detected as the predominant etiological agent (100%) in HIV-positive patients. No genetic polymorphic changes were found. CONCLUSIONS: No correlation was observed between the analyzed TNFα polymorphisms and cryptococcal meningitis.