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Resumo Na primeira metade do século XX, a Região Carbonífera Catarinense passou por um intenso processo de industrialização que impactou diretamente as diferentes formas de vida. Como resultado da exploração do carvão mineral, a região enfrentou uma série de problemas sanitários que dificultavam o próprio processo de acumulação do capital. Diante da incapacidade de o poder público atender às demandas sanitárias, o empresariado local estabeleceu parcerias com congregações religiosas femininas para prestar serviços assistenciais em suas vilas operárias. Como resultado dessa relação, as Pequenas Irmãs da Divina Providência produziram um álbum/relatório, composto por textos, desenhos e fotografias que retratam suas atividades assistenciais, entre 1955 e 1957, em uma das vilas da região.
Abstract During the first half of the twentieth century, the coal-producing region of Santa Catarina state underwent intense industrialization that directly impacted various ways of life; various health problems emerged in the region as a result of coal mining and impeded economic progress. As the government was unable to meet health demands, local businesses established partnerships with female religious orders that provided assistance services in the villages where workers lived. As part of such a partnership, the Pequenas Irmãs da Divina Providência created an album of texts, drawings, and photographs as a report describing their activities from 1955 to 1957 in one such village in the region.
Subject(s)
Coal , Natural Resources Exploitation , Delivery of Health Care , Industrial Development , Health Services Needs and Demand , Brazil , History, 20th CenturyABSTRACT
Abstract INTRODUCTION: The aac(6')-Ib-cr and bla KPC genes are spreading among Enterobacteriaceae species, including Providencia stuartii, in some countries of world. METHODS: These genes were investigated in 28 P. stuartii isolates from a public hospital in Recife, Pernambuco, Brazil, by PCR and sequencing. RESULTS: The aac(6')-Ib-cr gene was detected in 16 resistant isolates, and the bla KPC gene was seen in 14. CONCLUSIONS: The presence of these genes in P. stuartii multi- and extensively drug-resistant isolates indicates that the resistance arsenal of this species is increasing, thus limiting the therapeutic options.
Subject(s)
Humans , Enterobacteriaceae Infections , Plasmids , beta-Lactamases/genetics , Brazil , Microbial Sensitivity Tests , Providencia , Drug Resistance, Multiple, Bacterial , Anti-Bacterial Agents/pharmacologyABSTRACT
Purple Urine Bag Syndrome (PUBS) is a rare presentation of urinary tract infection caused by certain bacteria that produce sulphatases and phosphatases that bring about metabolism of tryptophan, leading to production of pigments indigo and indirubin that together impart purple colour of urine. It is a benign condition, most often associated with long term urinary catheterization, renal diseases, chronic constipation and female gender. Commonly implicated organisms include Proteus mirabilis, Klebsiella pneumoniae, Providencia stuartii. Diagnosis is made on urinary culture. Treatment includes reassurance and antibiotics for UTI. We present a case of purple urinary bag syndrome in a female patient of carcinoma stomach presenting with gastric outlet obstruction.
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Se presenta un caso de un hombre con diagnóstico de osteomielitis crónica con aislamiento en cultivo de hueso de Providencia rettgeri productora de carbapenemasa de tipo Nueva Delhi. El paciente presentó control de la infección por este germen con terapia antibióticacombinada con cefepime y gentamicina. Es el primer reporte de una infección por enterobacterias con este mecanismo de resistencia en la región.
We reported a case in a man with chronic osteomyelitis of an isolate of Providencia rettgeri carrying New-Delhi metallo-beta-lactamase. The isolate was obtained from the patient's bone culture. The infection was controlled with combined antibiotic therapy (cefepime and gentamicine). This is the first report of an infection produced by Enterobacteriaceae carrier of this metallo-beta-lactamase in the region.
Subject(s)
Humans , Male , Middle Aged , Osteomyelitis , Anti-Bacterial Agents , beta-Lactamases , Gentamicins , Colombia , Enterobacteriaceae , CefepimeABSTRACT
El objetivo del presente trabajo de investigación fue conocer las indicaciones más frecuentes de sedación paliativa en pacientes -hombres y mujeres- que estuvieron ingresados en una unidad de cuidados paliativos, así como los diagnósticos oncológicos, el tipo de sedación y las dosis administradas,y determinar si se logró un adecuado control de los síntomas. Esto es relevante debido a que no se cuenta con datos nacionales referentes a esta terapéutica. El tipo de investigación fue descriptiva, con diseño retrospectivo en la cual se realizó una revisión de expedientes de los pacientes ingresados en el Hospital de cuidados paliativos Divina Providencia de El Salvador, en el periodo de noviembre de 2014 a abril de 2015. Se seleccionó una muestra no probabilista por conveniencia de 49 pacientes. Según los datos obtenidos, se observó que el 30% de los pacientes necesitaron sedación paliativa sin diferencia de género; además se estableció que el 69.4% de los pacientes se encontraban entre los 50 y los 79 años. La indicación de mayor frecuencia para administrar sedación paliativa fue la disnea, con un 34.7%, lo cual corresponde a la prevalencia de cáncer pulmonar que se situó en un 12,2%, y metástasis pulmonares con el 26.5% en la mayoría de pacientes. Sin embargo, la enfermedad oncológica de mayor prevalencia fue cáncer gastrointestinal, con el 18.4%. Más del 80% de los pacientes ingresados en el periodo de tiempo revisado recibieron una sedación paliativa de tipo continua y profunda. El 100% fue sedado con una benzodiacepina (Midazolam), con una dosis media de 60mg en 24 horas. En ningún paciente se utilizó neuroléptico como sedante. En el 63.3% de los pacientes con sedación paliativa se logró un control de síntomas y confort mediante una sedación de tipo profunda. Se estudió la relación de diferentes variables como nivel de Ramsay y confort del paciente (EDAF), metástasis y tipo de cancer, indicación de sedación y metástasis, las cuales el valor de chi2 determina relación estadística significativa. Los resultados difieren de los encontrados en guías e investigación internacionales, probablemente debido a la idiosincrasia de los pacientes o a la forma en que se aplican los protocolos establecidos.
Subject(s)
Medical Oncology , Conscious SedationABSTRACT
Resumo O objetivo deste texto é analisar os mecanismos e operacionalização do Estado-providência em sua produção de certo tipo de "servilismo cidadão", por via da capitalização dos interstícios mais cotidianos e globais da vida dos indivíduos na sociedade capitalista. O texto demonstra ainda a forma como o neoliberalismo acaba por obliterar essa proposta ao presumir, enquanto regime de veridição para a gestão da seguridade social, o mercado como ente definidor do campo de intervenção da política social e a vinculação entre moral do trabalho e pobreza no acesso aos direitos sociais.
Abstract This text aims at analyzing the mechanisms and operationalization of the welfare state in its production of a certain kind of "citizen servility" by the capitalization of the most daily and global interstices in the individuals´ lives in the capitalist society. It also shows the way neoliberalism ultimately obliterates such a proposal when, as a veridiction regime for the management of social security, it assumes the market is a defining entity of the social policy intervention field and the linking between work ethic and poverty in the access to social rights.
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Objective To understand the changing resistance proifle ofProteus,Serratia,Citrobacter,Morganella andProvidencia in hospitals across China according to the data from CHINET Antimicrobial Resistance Surveillance Program 2005-2014.Methods Antimicrobial susceptibility was tested by using Kirby-Bauer method or automatic minimum inhibitory concentration determination according to a uniifed protocol.Results A total of 21 663 clinical isolates were collected from January 2005 to December 2014. The proportion ofProteus andSerratia isolates increased with time from 1.41% in 2005 to 2.09% in 2014, and from 0.99% in 2005 to 1.28% in 2014 among all the isolates. No change was found for the proportion ofCitrobacter,Morganella, orProvidencia. Less than 10% of theProteus isolates were resistant to cefoperazone-sulbactam, piperacillin-tazobactam, ceftazidime, cefoxitin, amikacin and tigecycline. Less than 10% of theSerratia isolates were resistant to cefoperazone-sulbactam, piperacillin-tazobactam, amikacin and tigecycline. Less than 20% of theCitrobacter isolates were resistant to cefoperazone-sulbactam, piperacillin-tazobactam, cefepime, amikacin and tigecycline. Less than 10% of theMorganella isolates were resistant to cefoperazone-sulbactam, piperacillin-tazobactam, cefepime, amikacin and tigecycline. Less than 20% of theProvidencia isolates were resistant to cefoperazone-sulbactam, piperacillin-tazobactam, cefepime, cefoxitin and tigecycline.Conclusions The antibiotic resistance ofProteus,Serratia, Citrobacter,Morganella andProvidencia isolates in hospitals across China is growing during the period from 2005 to 2014. Strengthening infection control and rational antibiotic use are effective to slow the growth of drug resistance.
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BACKGROUND/AIMS: Providencia species frequently colonize urinary catheters and cause urinary tract infections (UTIs); however, bacteremia is uncommon and not well understood. We investigated the clinical features of Providencia bacteremia and the antibiotic susceptibility of Providencia species. METHODS: We identified cases of Providencia bacteremia from May 2001 to April 2013 at a tertiary care hospital. The medical records of pertinent patients were reviewed. RESULTS: Fourteen cases of Providencia bacteremia occurred; the incidence rate was 0.41 per 10,000 admissions. The median age of the patients was 64.5 years. Eleven cases (78.6%) were nosocomial infections and nine cases (64.3%) were polymicrobial bacteremia. The most common underlying conditions were cerebrovascular/neurologic disease (n = 10) and an indwelling urinary catheter (n = 10, 71.4%). A UTI was the most common source of bacteremia (n = 5, 35.7%). The overall mortality rate was 29% (n = 4); in each case, death occurred within 4 days of the onset of bacteremia. Primary bacteremia was more fatal than other types of bacteremia (mortality rate, 75% [3/4] vs. 10% [1/10], p = 0.041). The underlying disease severity, Acute Physiologic and Chronic Health Evaluation II scores, and Pitt bacteremia scores were significantly higher in nonsurvivors (p = 0.016, p =0.004, and p = 0.002, respectively). Susceptibility to cefepime, imipenem, and piperacillin/tazobactam was noted in 100%, 86%, and 86% of the isolates, respectively. CONCLUSIONS: Providencia bacteremia occurred frequently in elderly patients with cerebrovascular or neurologic disease. Although Providencia bacteremia is uncommon, it can be rapidly fatal and polymicrobial. These characteristics suggest that the selection of appropriate antibiotic therapy could be complicated in Providencia bacteremia.
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , APACHE , Anti-Bacterial Agents/therapeutic use , Bacteremia/diagnosis , Cross Infection/diagnosis , Cross-Sectional Studies , Drug Resistance, Bacterial , Enterobacteriaceae Infections/diagnosis , Hospital Mortality , Incidence , Microbial Sensitivity Tests , Predictive Value of Tests , Providencia/drug effects , Republic of Korea , Retrospective Studies , Risk Factors , Tertiary Care Centers , Treatment OutcomeABSTRACT
We report a suspicious case of spontaneous bacterial peritonitis (SBP) caused by Providencia rettgeri and Clostridium perfringens in a patient with alcoholic cirrhosis. The patient presented with altered mentality and was taken to the emergency room. He was diagnosed with SBP after abdominal paracentesis and computed tomography and was treated with ceftriaxone and metronidazole. The pathogens were identified under suspicion of polymicrobial infection because of Gram-staining discrepancies between broth from blood culture bottles and colonies on solid media. He died of septic shock despite transfer to the intensive care unit. Although we could not conclude which organism had the leading role in this case of SBP and septicemia, we did verify the importance of Gram staining in a microbiology laboratory in terms of quality assurance.
Subject(s)
Humans , Ceftriaxone , Clostridium perfringens , Coinfection , Emergency Service, Hospital , Intensive Care Units , Liver Cirrhosis, Alcoholic , Metronidazole , Paracentesis , Peritonitis , Providencia , Sepsis , Shock, SepticABSTRACT
Objective To study the distribution and drug resistance of clinical Providencia stuartii isolates and provide the basis data for clinical therapy.Methods A data analysis for the specimen source,the distribution of departments with infection and the antibiotic susceptibility results to 76 isolates was conducted in retrospectively. Results Among 76 strains were mainly from sputum (71.1%),wound secretions (10.5%) and blood (6.6%);the proportion of these strains from ICU was 40.8%,from respiratory department was 9.2%and from general surgery was 7.9%;The bacteria's drug resistance was more serious,multi drug resistant (MDR) strains accounted for 65.8%,pan drug resistant ( PDR) strains accounted for 26.3%,the mortality of patients with PDR strains infection was 45.0%,which was higher than 5.8%of no PDR strains infection.A low resistance rate of antibiotics were imipenem,fluoro-quinolones andamikacin,et al,and the rate of imipenem resistant was lowest(31.5%).Conclusion The multidrug resistance phenomenon of Providencia stuartii is serious, the first choice for the treatment is imipenem, the second choice was fluoroquinolones or amino glycopeptides antibiotics,the hospital infection caused by the bacterium infection in monitoring should be strengthened.
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In the Colombian Caribbean, the marine macroalgal flora of the Seaflower International Biosphere Reserve has been little studied, despite its ecological importance. Historical records have reported only 201 macroalgae species within its area of almost 350 000km². However, recent surveys have shown a diversity of small algae previously overlooked. With the aim to determine the macroalgal diversity in the Reserve, we undertook field surveys in different ecosystems: coral reefs, seagrass beds, and rocky and sandy substrates, at different depths, from intertidal to 37m. During these field surveys, we collected a small described species belonging to the genus Crouania (Callithamniaceae, Rhodophyta), Crouania pumila sp. nov. that is decribed in this paper. This new species was distinguished from other species of the genus by a distinctive suite of traits including its diminutive size (to only 3.5mm in length), its decumbent, slightly calcified habit (epiphytic on other algae), its ramisympodial branching, the ecorticate main axes, and the elongate shape of the terminal cells of the cortical filaments. The observations were provided for both female (cystocarpic) and tetrasporangiate thalli; however, male thalli were not seen. Further studies have to be undertaken in this Reserve in order to carry out other macroalgal analysis and descriptions.
Crouania pumila sp. nov. (Ceramiaceae, Rhodophyta) es descrita para la isla de Providencia, en el Caribe colombiano. La nueva especie se destaca de las otras especies del género por características como su tamaño diminuto (hasta 3.5mm de largo), su hábito decumbente y poco calcificado (epífita sobre otras algas), su ramificación ramisimpodial, la ausencia de corticación y la forma alargada de las células terminales de los filamentos corticales. Se proveen observaciones sobre talos femeninos (cistocárpicos) y tetraspóricos. No se observaron talos masculinos.
Subject(s)
Ecosystem , Rhodophyta/anatomy & histology , Rhodophyta/classification , Caribbean Region , Colombia , Population DensityABSTRACT
Se presenta el caso de un paciente con osteomielitis por Providencia rettgeri. Recibía warfarina, por trombosis venosa profunda de miembro inferior izq.; durante su evolución antes de ingresar al Hospital General del Oeste, Caracas, Venezuela, presentó una infección secundaria a la avulsión de la uña, con varias hospitalizaciones en otros centros de salud. Hubo un antecedente no comprobado de diabetes mellitus. Se analiza el caso y se revisa la literatura en la que no se encontró descripción con compromiso de partes blandas en la literatura nacional o latinoamericana.
A case of osteomyelitis due to Providence rettgeris presented by in a patient who was receiving warfarin for a deep vein thrombosis of the left lower limb. He also presented asoft tissue infection secondary to nail avulsion and was hospitalized several times berfore being admitted to the Hospital General del Oeste, Caracas, Venezuela. There was a history of possible diabetes mellitus which was not proven. We reviewed the nationaland Latin American literature analyzed, but description of P. rettgeri was found with soft tissue involvement in reviewed literature.
Subject(s)
Humans , Male , Aged , Necrosis/surgery , Necrosis/pathology , Osteomyelitis/diagnosis , Osteomyelitis/therapy , Venous Thrombosis/surgery , Venous Thrombosis/diagnosis , Warfarin/therapeutic use , Internal MedicineABSTRACT
A prostatic abscess is a rare, but potentially serious disease. The mainstay of treatment for the prostatic abscess is antibiotic administration and drainage. Here, we experienced a 66-year-old man with a prostatic abscess caused by Providencia rettgeri, which has not been reported as a pathogenic agent of a prostatic abscess. He was cured using antibiotics, without surgical drainage. This case suggests that the appropriate selection of patients for antibiotic therapy may provide an excellent prognosis.
Subject(s)
Humans , Abscess , Anti-Bacterial Agents , Drainage , Prognosis , Prostate , ProvidenciaABSTRACT
Purpose: To study the resistance to third-generation cephalosporins in Providencia stuartii strain isolated from hospitalized patient in Tunisia and to identify the responsible genes Materials and Methods: This strain was analysed by PCR and sequencing to identify the genes responsible for the β-lactamase resistance phenotypes. The transferability of the phenotypes was tested by conjugation to Escherichia coli J53. The isoelectric point was determinate by isoelectrofocalisation. Results: This resistance was carried by a 60 kb plasmid that encoded a β-lactamase with a pI of 5.4. This β-lactamase revealed identity with the blaTEM-1 gene encoding the TEM-1 β-lactamase, except for a replacement of the Val residue at position 84 by Ile, and the Ala residue at position 184 by Val. These two mutations were encountered in TEM-116 β-lactamase. Conclusion: This study demonstrates the first description of TEM-116 in the P. stuartii species in the world and the first one in a Tunisian hospital.
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Se registra la presencia del helecho invasor Pteridium caudatum (L.) Maxon en la isla de Providencia, Colombia. La especie ha sido encontrada como planta decorativa en jardines y patios, así como naturalizada en El Pico, la localidad boscosa con mejor estado de conservación de la isla. Se discuten las implicaciones ecológicas relativas a la presencia de esta especie.
We report for the first time the presence of the invasive fern Pteridium caudatum (L.) Maxon Old Providence Island, Colombia. The species was found as an ornamental plant in house backyards, as well as in the wild in the locality The Peak, the best preserved area of the island. We discuss the ecological implications associated to the presence of this species.
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Providencia rettgeri is a member of Enterobacteriacea that is known to cause urinary tract infection (UTI), septicemia, and wound infections, especially in immunocompromised patients and in those with indwelling urinary catheters. We experienced a case of UTI sepsis by Providencia rettgeri in a patient with spinal cord injury. The patient had only high fever without urinary symptoms or signs after high dose intravenous methylprednisolone. The laboratory results showed leukocytosis (21,900/microL, segmented neutrophils 91.1%) and pyuria. Cefepime was given empirically and it was switched to oral trimethoprim-sulfamethoxazole because P. rettgeri was identified from blood and urine culture which was susceptible to TMP-SMX. The patient was improved clinically but P. rettgeri was not eradicated microbiologically. To the best of our knowledge, this is the first case report on sepsis caused by Providencia rettgeri in Korea.
Subject(s)
Humans , Cephalosporins , Fever , Immunocompromised Host , Korea , Leukocytosis , Methylprednisolone , Neutrophils , Providencia , Pyuria , Sepsis , Spinal Cord Injuries , Trimethoprim, Sulfamethoxazole Drug Combination , Urinary Catheters , Urinary Tract Infections , Wound InfectionABSTRACT
Snakebite is very common especially in Asia. We report a rare case of Providencia rettgeri infection following snakebite on the foot. This patient was treated with early and aggressive wound debridement, daily wound dressing during hospitalization and then skin coverage with split skin graft. No anti venom was given administered. Appropriate intravenous antibiotics were given to the patient while hospitalized and oral antibiotic were prescribed upon discharge. The outcome of this treatment was successful.
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OBJECTIVE To study the classification the ?-lactamases produced by Providencia spp.METHODS To detect the ?-lactamases produced by 19 strains of Providencia spp with nitrocefin test,a multi-disk test(synergy test,antagonized test for the inducible AmpC ?-lactamases(IABLs),AmpC ?-lactamases(ABLs) phenotype test and extended-spectrum ?-lactamases(ESBLs) screening test,carbapenem-hydrolyzing ?-lactamases(CHBLs).RESULTS The nitrocefin tests of all of 19 strains were positive,producing the ?-lactamases(100.0%);eight strains produced broad-spectrum ?-lactamases(BSBLs,42.1%) and ESBLs(42.1%),respectively,one strain produced overexpression of AmpC,3 strains produced CHBLs.CONCLUSIONS The rate of ?-lactamases produced by the 19 strains of Providencia spp is very high,there are three kinds of ?-lactamases,mainly BSBLs and ESBLs.
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BACKGROUND: VIM-2 type metallo-beta-lactamase (MBL) producing strains are presently spreading to Pseudomonas spp., Acinetobacter spp. and even to Enterobacteriaceae such as Serratia marcescens, Enterobacter cloacae and Klebsiella pneumoniae in Korea. Recently we determined the phenotype and the genotype of three MBL-producing Providencia rettgeri isolated from urinary specimen of three patients with neurosurgical ward, and analyzed the blaVIM-2 containing integron of a P. rettgeri CBU852. METHODS: EDTA-disk synergy test was used for the screening of MBL, and the PCR for blaIMP-1, blaVIM-1 and blaVIM-2 was performed. The minimal inhibitory concentration of those isolates was determined by broth microdilution method, and the genomic DNA fingerprinting analysis was performed by random amplified polymorphic DNA (RAPD). The sequence of the blaVIM-2 containing integron was determined. RESULTS: Three P. rettgeri with reduced imipenem susceptibility showed the positive EDTA-disk synergy test and blaVIM-2 was detected by PCR. Antimicrobial susceptibility test showed the resistance to all beta-lactams tested, ciprofloxacin and aminoglycoside such as gentamicin, tobramycin and amikacin, indicating multidrug resistance of those isolates. RAPD analysis showed the identical DNA fingerprint of those three isolates. The novel class 1 integron, including aacA4, blaVIM-2, orf "ii" and orf "iii", was detected in a P. rettgeri CBU852. CONCLUSIONS: In this study, the multidrug resistant P. rettgeri CBU852 had blaVIM-2 containing novel class 1 integron. The emergence of blaVIM-2 producing P. rettgeri could compromise the use of carbapenem in treatment of infections caused by MBL producing bacteria. To our knowledge, this is the first report that VIM-2 MBL gene has been detected in P. rettgeri.
Subject(s)
Animals , Humans , Acinetobacter , Amikacin , Bacteria , beta-Lactams , Ciprofloxacin , DNA , DNA Fingerprinting , Drug Resistance, Multiple , Ecthyma, Contagious , Enterobacter cloacae , Enterobacteriaceae , Genotype , Gentamicins , Imipenem , Integrons , Klebsiella pneumoniae , Korea , Mass Screening , Phenotype , Polymerase Chain Reaction , Providencia , Pseudomonas , Serratia marcescens , TobramycinABSTRACT
Providencia stuartii is occasionally isolated from patients with chronic otitis media, however it has not been reported as a cause of acute otitis media so far. We recently isolated P. stuartii from the pus specimen of right middle ear of a 2-year-old patient with acute otitis media. The patient was admitted because of right-sided otorrhea for 2 weeks. The symptom was not relieved by first-line empirical antibiotics (amoxicillin-clavulanic acid and netilmicin), but it was subsided dramatically with the changed antibiotics (ceftriaxone and amikacin); the isolate was susceptible to these two antibiotics in in vitro susceptibility testing. To our knowledge, this is the first case report of acute otitis media caused by P. stuartii.