ABSTRACT
Abstract Antimicrobial treatment of patients with bloodstream infections (BSI) is time-sensitive. In an era of increasing antimicrobial resistance, rapid detection and identification of bacteria with antimicrobial susceptibility are critical for targeted therapy early in the disease course. This study describes the performance of a rapid method for identifying and testing antimicrobial susceptibility of Gram-negative bacteria performed directly from blood culture bottles in a routine microbiology laboratory. A total of 284, 120, and 24 samples were analyzed by rapid identification (Rid), rapid susceptibility testing (RAST), and rapid broth microdilution for polymyxin B (rMIC), respectively, and compared with standard methods. Our protocol was able to identify 93% of isolates at the species level using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). We obtained 100% agreement for RAST compared to the standard method and 96% agreement for rMIC. Our protocol has proven to be an excellent tool for rapid identification of Gram-negative bacilli causing BSIs. It can also be used in microbiology laboratory routine along with RAST and faster polymyxin microdilution, especially for carbapenemase-producing bacteria, allowing for rapid, simple, accurate, and cost-effective diagnosis.
ABSTRACT
Abstract Purpose: To evaluate the concentration of transforming growth factor beta 1 (TGFB1) levels in a rat pleural effusion obtained by inoculation of intrapleural bacteria or turpentine through thoracentesis. Methods: Thirty-Nine Wistar rats were divided into three groups: Staphylococcus aureus (SA, n = 17); Streptococcus pneumoniae (SP, n = 12); and turpentine (control, n = 10). Pleural fluid was collected through ultrasound-guided thoracentesis 12 h, 24 h, and 36 h after instillation of bacteria or turpentine. Levels of TGFB1 were measured in pleural fluid. Results: At 12 h, mean TGFB1concentrations were 5.3450 pg/mL in the SA group, 5.3449 pg/mL in the SP group, and 5.3450 pg/mL in controls. At 24 h, they were 4.6700 pg/mL in the SA group, 4.6700 pg/mL in the SP group, and 4.6700 pg/mL in controls. At 36 h, they were 4.6699 pg/mL in the SA group and in control. No difference was observed among the groups in mean TGFB1concentration (p = 0.12); however, a significant intragroup reduction in mean TGFB1 was observed between 12 and 24 h (p < 0.01). Conclusion: The transforming growth factor beta 1 concentrations were not useful as a diagnostic tool or an early marker of infected pleural effusion.
Subject(s)
Animals , Male , Rats , Pleural Effusion/diagnosis , Empyema, Pleural/diagnosis , Transforming Growth Factor beta1/analysis , Pleural Effusion/complications , Bacteria/pathogenicity , Biomarkers/analysis , Empyema, Pleural/complications , Empyema, Pleural/microbiology , Rats, Wistar , Disease Models, AnimalABSTRACT
INTRODUÇAO: A histoplasmose pulmonar aguda depende da inalação de uma grande quantidade de propágulos fúngicos por um paciente hígido. O tempo de exposição determina a gravidade da doença. Uma epidemia é influenciada por fatores que afetam o crescimento e a transmissão do Histoplasma capsulatum var. capsulatum na natureza. OBJETIVO: Identificar os aspectos epidemiológicos e clínico-laboratoriais dos pacientes com histoplasmose pulmonar aguda no Rio Grande do Sul e compará-los com as microepidemias relatadas no Brasil. MÉTODO: Foram revisados 212 prontuários clínicos de pacientes com histoplasmose dos arquivos do Laboratório de Micologia do Complexo Hospitalar Santa Casa de Porto Alegre (RS) num período de 25 anos (1977-2002). Foram identificados e incluídos no estudo os casos de histoplasmose pulmonar aguda com cultivo positivo e/ou achado histopatológico compatível. As microepidemias foram diagnosticadas com a comprovação de um caso ou evidência soromicológica com história clínica compatível. Foram revisadas as microepidemias publicadas no Brasil. RESULTADOS: Dezoito de um total de 212 pacientes (8,5 por cento) foram incluídos no trabalho. A idade variou de 8 a 63 anos (média de 35,4; mediana de 34,5), e 67 por cento eram do sexo masculino. A história epidemiológica foi sugestiva em 11 pacientes (61 por cento). O tipo primário de histoplasmose pulmonar aguda foi o mais freqüente (17; 95 por cento). Houve predomínio de casos isolados. CONCLUSAO: O reconhecimento de casos isolados e a presença de microepidemias demonstram a abundância do H. capsulatum no solo, e juntamente com a ocorrência de todas as formas da doença, confirmam o Rio Grande do Sul como hiperendêmico para histoplasmose.
Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Histoplasma , Histoplasmosis , Lung Diseases, Fungal/epidemiology , Acute Disease , BrazilABSTRACT
Apresentam-se dois casos de Histoplasmose Pulmonar Cronica e outros onze casos da literatura brasileira sao comentados. Apos cura clínica, um de nossos pacientes apresentou bola fungica aspergilar intracavitaria, na parede da cavidade foi identificado H. capsulatum. Comentam-se aspectos diagnosticos da micose
Subject(s)
Humans , Male , Middle Aged , Antifungal Agents/therapeutic use , Histoplasmosis/diagnosis , Lung Diseases, Fungal/therapy , Biopsy , Cavitation , Follow-Up Studies , Immunodiffusion/methods , Airway Obstruction/diagnosis , Radiography, Thoracic/methodsABSTRACT
Säo relatados dois casos de histoplasmose pulmonar aguda ocorridos em casal de adultos jovens e comenta-se a importância epidemiológica do problema no Rio Grande do Sul