ABSTRACT
OBJECTIVE: To characterize mechanical ventilation-associated pneumonia (MVAP). METHOD: This is an observational descriptive study to characterize MVAP in 61 ventilated patients admitted in the intensive care units of the Hermanos Ameijeiras hospital during 2011. This study also aimed to isolate the bacteria causing MVAP and characterize their resistance to antibiotics. RESULTS: 51 (83.60%) patients presented pulmonary infiltrates and 35 (50.81%) presented a clinical score > 6 according to the Clinical Pulmonary Infection Score. Acinetobacter baumannii and Pseudomonas aeruginosa were the most frequently isolated microorganisms from patients with MVAP. Both microorganisms showed a high resistance to antibiotics. Carbapenems were the most frequent used antimicrobial therapeutic agents; elective antibiotic combinations were directed against both bacterial wall structure and nucleic acid synthesis. CONCLUSION: Patients with MVAP identified during the studied period showed similar frequency to those reported in medical literature. Thus, this study corroborated that this is still a relevant medical problem in this hospital. Acinetobacter baumannii and Pseudomonas aeruginosa were the most frequently isolated microorganisms from patients with MVAP. Antimicrobial treatment, empirical or not, are still the main risk factors for the development of multidrug-resistant strains of bacteria. The rate of resistance to antibiotics of Acinetobacter baumannii and Pseudomonas aeruginosa strains isolated from patients with MVAP was higher than those isolated from infected patients without MAVP. Tigecycline and colistin were the only antibiotics fully effective against Acinetobacter baumannii strains isolated in 2011 from patients with MVAP; against Pseudomonas aeruginosa strains, only colistin was fully effective.
Subject(s)
Female , Humans , Male , Middle Aged , Anti-Bacterial Agents/pharmacology , Gram-Negative Bacteria/drug effects , Gram-Positive Bacteria/drug effects , Pneumonia, Ventilator-Associated/microbiology , Gram-Negative Bacteria/isolation & purification , Gram-Positive Bacteria/isolation & purification , Intensive Care Units , Microbial Sensitivity TestsABSTRACT
INTRODUCCIÓN: la infección por Paracapillaria philippinensis (Capillaria philippinensis), se caracteriza clínicamente como una enteropatía progresiva, con pérdida masiva de proteínas y un síndrome de malabsorción que puede llegar a ser mortal. OBJETIVO: reportar por primera vez en Cuba el hallazgo de infección humana por P. philippinensis. MÉTODOS: se describió el caso de un paciente de 21 años de edad, del sexo masculino, procedente de Ciudad de La Habana, y que nunca había viajado fuera del país. Ingresa porque después de la ingestión de un pescado empanado comenzó a presentar un cuadro diarreico que se fue intensificando con el transcurrir de los días, llegando a tener más de 15 deposiciones líquidas diarias, abundantes en cantidad, sin flemas ni sangre, acompañado de un cuadro de desnutrición severa, y síntomas generales de astenia y anorexia intensas. RESULTADOS: el diagnóstico de laboratorio confirmó la presencia en heces de huevos de P. philippinensis. CONCLUSIONES: las características clínicas del paciente y el hallazgo de una eosinofilia moderada, coinciden con lo descrito en la literatura. En nuestro conocimiento, este es el primer hallazgo de infección autóctona por P. philippinensis en humanos que se realiza en Cuba, y en el continente americano. Es importante la alerta epidemiológica sobre la posible emergencia de esta parasitosis en nuestra zona geográfica, sobre todo en aquellos lugares donde la costumbre de comer pescado crudo o mal cocido sea parte del contexto cultural.
INTRODUCTION: the infection caused by Paracapillaria philippinensis (Capillaria philippinensis) is clinically characterized as a progressive enteric illness with massive loss of proteins and a malabsorption syndrome that may become fatal. OBJECTIVE: the first report in Cuba of human infection with P. philippinensis. METHODS: the case of a Cuban male patient aged 21 years from the City of Havana, who had never been abroad, was described. This young man was admitted to the hospital because after having eaten one breadcrumb-covered fish, he started having diarrheic episodes that progressively increased up to more than 15 abundant diarrheas per day, without phlegm or blood, and a clinical picture of severe malnutrition and general symptoms of intensive asthenia and anorexia RESULTS: the lab diagnosis confirmed the presence of P. philippinensis eggs in feces. CONCLUSIONS: the clinical features of the patient and the finding of moderate eosinophilia in the hematological study agreed with published information. As far as we know, this is the first finding of a human infection caused by P. philippinensis in Cuba, and in the American continent as well. The epidemiological alert on the possible emergence of new cases of this parasitic infection in our geographic zone is important, mainly in those places where the habit of eating raw or undercooked fish is part of the local culture.
Subject(s)
Animals , Humans , Male , Young Adult , Capillaria , Enoplida Infections/diagnosis , CubaABSTRACT
Se ensaya un sistema de clasificación para el marcaje fagotípico de 18 cepas de Mycobacterium tuberculosis, utilizando un juego de 10 micobacteriofágos, que incluye 4 fagos mayores y 6 fagos auxiliares o de subdivisión. De las 18 cepas se obtuvieron 5 del tipo A0, 3 del tipo A2, 3 de los tipos A4, A5 y B, que no habían sido informadas anteriormente en el país y I del tipo A3. Se logró una apertura en la diferenciación de las cepas de M. tuberculosis en el número de 16 subtipos diferentes, de los 6 tipos incialmente encontrados por el esquema, con los fagos mayores