ABSTRACT
INTRODUCTION: Acinetobacter spp. have emerged as notorious pathogens involved in healthcareassociated infections. Carbapenems are important antimicrobial agents for treating infections due to multidrug resistant Acinetobacter spp. Different mechanisms may confer resistance to these drugs in the genus, particularly production of class D carbapenemases. OXA-23-like family has been pointed out as one of the predominant carbapenamases among Acinetobacter. The present work aimed to investigate the occurrence of OXA-23-like carbapenemases among Acinetobacter isolates recovered from patients of a university hospital in Niterói, RJ, Brazil. METHODS: Antimicrobial susceptibility profiles were determined by disk-diffusion. Imipenem resistant isolates were submitted to Modified Hodge Test in order to screen for carbapenemase production, and later to polymerase chain reaction (PCR) to investigate the presence of blaOXA-23. RESULTS: Imipenem and meropenem resistance rates were 71.4% and 69.7%, respectively. The Modified Hodge Test revealed carbapenemase production among 76 (89.4%) of the 85 imipenem resistant isolates analyzed; according to PCR results, 81 isolates (95.4%) carried the blaOXA-23 gene. CONCLUSIONS: OXA-23-like enzymes may be an important mechanism of carbapenem resistance among isolates present in the hospital studied.
Subject(s)
Humans , Acinetobacter/enzymology , beta-Lactamases/analysis , Acinetobacter/drug effects , Acinetobacter/isolation & purification , Anti-Bacterial Agents/pharmacology , Brazil , Disk Diffusion Antimicrobial Tests , Drug Resistance, Bacterial , Hospitals, University , Microbial Sensitivity Tests , Polymerase Chain Reaction , beta-Lactamases/geneticsABSTRACT
OBJETIVO: Foram avaliados retrospectivamente nove casos de discite na infância, confirmando suas formas variadas de apresentação, que levam ao atraso e dificuldades no diagnóstico. MÉTODOS: Os autores demonstraram que as radiografias iniciais podem se apresentar sem alterações, sendo importantes os exames de cintilografia ou ressonância magnética, nesses casos. RESULTADOS E CONSLUSÕES: Um paciente necessitou de tratamento cirúrgico para descompressão do canal lombar, devido à presença de abscesso discal. Os demais pacientes foram tratados conservadoramente, através de repouso, antibioticoterapia adequada e imobilização. Todos os pacientes evoluíram satisfatoriamente, e não apresentavam queixas nas suas avaliações finais.
Subject(s)
Child , Child, Preschool , Female , Humans , Infant , Male , Discitis/diagnosis , Anti-Bacterial Agents/therapeutic use , Bacterial Infections/diagnosis , Bacterial Infections/drug therapy , Bacterial Infections/microbiology , Discitis/microbiology , Discitis/therapy , Follow-Up Studies , Magnetic Resonance Imaging , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
Os autores relatam o caso de um paciente do sexo masculino, adulto jovem portador de hemangioendotelioma intravascular vegetante de Masson localizado na regiäo lombar apresentando-se clinicamente através de lombociatalgia esquerda. Patologia rara, sendo encontrado apenas um caso descrito na literatura com localizaçäo semelhante. Ressaltamos a importância do diagnóstico preciso para näo submeter os pacientes a tratamentos desnecessários.