Bacterial and fungal infectious etiology causing mastitis in dairy cows in the highlands of Boyacá (Colombia) / Etiología bacteriana y micótica infecciosa causante de mastitis en vacas lecheras en el altiplano boyacense (Colombia)

ABSTRACT Mastitis is one of the most important diseases for the dairy industry worldwide due to the great economic losses it causes, and the bacterial agents that cause it vary from one herd to another. The objective of the investigation was to determine the infectious agents involved in the development of mastitis in specialized dairies herds in the Highlands of Boyacá, Colombia. Was performed CMT tests in 4432 teats to determine the positive results for inflammation (CMT + 2), sampling in aseptic material of positives quarters, identification and differentiation through microbiological cultures, Gram staining, and biochemical tests of bacterial and fungal agents present in milk samples. It was determined that the total prevalence varied in the three years of the study as follows: in 2016, 45.19%; in 2017, 51.06% and in 2018, 39.76%. The months of April, May, and September, October presented the highest number of teats affected with mastitis during the three years of study. Streptococcus agalactiae and Staphylococcus aureus were the most prevalent microorganisms that cause mastitis in the three study years. There was an increase in the prevalence of infected teats corresponding to the months (April, May, September, and October) due to rainfall increases. The contagious pathogens were most prevalent that environmental pathogens.

RESUMEN La mastitis es una de las enfermedades más importantes para la industria lechera a nivel mundial debido a las grandes pérdidas económicas que genera; además, los agentes que la generan varían de un rebaño a otro. El objetivo de esta investigación fue determinar los agentes infecciosos involucrados en el desarrollo de mastitis en lecherías especializadas del departamento de Boyacá (Colombia). Se realizaron pruebas de CMT a 4432 cuartos para determinar los positivos a inflamación (CMT+2), toma de muestras en material aséptico de cuartos positivos, identificación y diferenciación a través de cultivos microbiológicos, tinción de Gram y pruebas bioquímicas de los agentes bacterianos y micóticos presentes en las muestras de leche. Se determinó que la prevalencia total varió en los tres años de estudio así: en el año 2016, 45,19%; en el 2017, 51,06%, y en el 2018, 39,76%. Los meses de abril-mayo y septiembre-octubre presentaron la mayor cantidad de cuartos afectados con mastitis a lo largo de los tres años de estudio. Finalmente, se determinó que Streptococcus agalactiae y Staphylococcus aureus, microorganismos que generan mastitis, fueron los de mayor prevalencia durante los tres años de estudio debido a un aumento en las lluvias. Los patógenos contagiosos causantes de mastitis fueron los más prevalentes, por encima de los medioambientales.

Ventilator-associated pneumonia agents in Brazilian Neonatal Intensive Care Units - a systematic review

ABSTRACT Introduction Ventilator-associated pneumonia (VAP) is one of the most common healthcare-associated infections (HAI) in neonates admitted in neonatal intensive care units (NICUs). Methods We did a systematic review using PRISMA methodology to identify the main etiological agents in Brazilian NICUs. Eligible studies published without period restriction were identified in PUBMED, SCIELO, LILACS and DOAJ. Studies were included if they were conducted in neonates hospitalized at NICU. Studies done in outpatient care, neonates outside NICU, emergency department, primary care, long-term care facilities or a combination of these were excluded. Results We identified 6384 articles in the initial search and four papers met the inclusion criteria. In all studies included, rates of device-associated infections were described, including VAP rates. The VAP incidence density, in exclusively Brazilian NICU, ranged from 3.2 to 9.2 per 1000 ventilator-days. Pneumonia was described as the main HAI in NICU in one article, as the second type of HAI in two other articles and as the fourth type of HAI in the last one. The main pathogens causing all HAI types were described in three of four articles, but, none of the articles reported which pathogens were related or associated to VAP. Conclusion Etiological agents causing VAP in Brazilian NICUs are, until the present time, not known.

Frecuencia y sensibilidad antimicrobiana de agentes etiológicos de dacriocistitis / Frequency and antimicrobial sensibility of etiological agents of dacriocystitis

La dacriocistitis representa la infección más frecuente del sistema lagrimal. El estudio microbiológico de las dacriocistitis es importante para la adecuada selección de los antibióticos. El objetivo del estudio es determinar la frecuencia y sensibilidad antimicrobiana de los agentes causantes de dacriocistitis en pacientes que acudieron a la Cátedra de Oftalmología del Hospital de Clínicas de mayo de 1998 a abril de 2007. Los pacientes no recibieron antibióticos por lo menos por una semana antes de la toma de muestra, que fueron tomadas por aspiración del contenido del saco lagrimal por el canalículo inferior o punción directa del saco lagrimal, y cultivadas en aerobiosis y anaerobiosis siguiendo métodos convencionales. De 41 pacientes (23 adultos y 18 niños), 30 (73,1%) presentaron cultivos positivos; 16 (53.4%) monomicrobianos y 14 (46,6%) polimicrobianos. Se aislaron 51 microorganismos, 37 en adultos y 14 en niños. El 54% de los microorganismos aislados en muestras de adultos correspondió a bacilos gramnegativos (enterobacterias, Haemophilus sp, anaerobios, y bacilos gramnegativos no fermentadores); 41% a cocos grampositivos (Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus viridans, y estafilococo coagulasa negativo); el 72% de los micro-organismos aislados en niños correspondió a cocos grampositivos (Staphylococcus aureus y Streptococcus pneumoniae), y en una muestra se aisló Candida sp. La sensibilidad del Streptococcus pneumoniae a la penicilina y la del Staphylococcus aureus a la meticilina fue de 100%. Los microorganismos aislados presentaron buena sensibilidad a los antimicrobianos, pero por la gran variedad de microorganismos y la naturaleza polimicrobiana de los cultivos se debería ampliar el esquema inicial de tratamiento y de la profilaxis de la dacriocistorrinostomía y otros procedimientos intraoculares. Una opción es el uso de aminopenicilinas con un inhibidor de betalactamasa; asociado con colirio de tobramicina en niños y ciprofloxacina en adultos.

Dacryocystitis is the most frequent infection of the lacrimal sac. The microbiological evaluation of dacryocystitis is important to make an adequate choice of antibiotics. The objective of this study is to determine the frequency and antibiotic susceptibility of the etiological agents of dacryocystitis in patients attending the Ophthalmology Department of the Teaching Hospital of the National University of Asunción, Paraguay from May 1998 to April 2007. All patients were antibiotic-free for at least one week prior to sampling. Samples were taken by aspiration of the lacrimal sac obtained via canalicular reflux or incision of the lacrimal sac and cultured aerobically and anaerobically following standard methods. Out of 41 patients (23 adults and 18 children), 30 (73.1%) showed positive cultures, 16 (53.4%) of them were pure and 14 (46.6%) mixed cultures, yielding 51 microorganisms. Of the 37 microorganisms 54% were isolated in adults and corresponded to gram negative rods (enterobacterias, Haemophilus sp, anaerobic and non fermenting gram negative rods) while 41% to gram positive cocci: (Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus viridans, coagulase negative Staphylococcus). In children, 72% of the micro-organisms isolated were gram positive cocci (Staphylococcus aureus and Streptococcus pneumoniae) and Candida sp was found in one sample. The susceptibility patterns of the Streptococcus pneumoniae to penicillin and Staphylococcus aureus to methicillin were 100%. All isolates showed high susceptibilities to the tested antibiotics. However, due to the great variety of species and the polymicrobial nature of the cultures, the initial scheme and prophylaxis of the dacryocystorhinostomy and other intraocular procedures should be expanded. One option is the use of aminopenicillins with a betalactamase inhibitor associated with tobramycin in children and ciprofloxacin in adults.

Infecções bacterianas em 100 pacientes submetidos a transplante cardíaco / Bacterial Infections in 100 Patients Submitted to Heart Transplantation

Objetivo - analisar as ocorrências, os agentes etiológicos e a apresentaçäo clínica referentes às infecçöes bacterianas diagnosticadas em grupo de pacientes submetidos a transplante (Tx) cardíaco. Métodos - foram considerados 100 doentes, observados consecutivamente, após Tx cardíaco. O período de seguimento variou de 3 a 90 (média 25,38 + ou - 25,96) meses. O reconhecimento das infecçöes bacterianas levou em conta os critérios estabelecidos pelos Centers for Disease Control. Resultados - as infecçs pulmonares bacterianas comparecem em maior número, havendo dificuldade para diagnosticá-las depois do Tx. Ocorreram comprometimentos motivados por bactérias em pele, mucosas, partes moles, ferida operatória, pericárdio, pleura, loja do marcapasso e vias urinárias, tendo também sido constatadas bacteremias e endocardites. Os agentes etiológicos, quando reconhecidos, ficaram devidamente especificados. Conclusäo - o período pós-operatório inicial é crítico, pois nos 30 dias subsequentes a ele as infecçöe acterianas surgem com maior frequência. Elas também suscitam maior preocupaçäo nas fases de tratamento dos episódios de rejeiçöes. Diagnóstico precoce e rápida adoçäo de medidas coercitivas podem evitar gravidade e evoluçäo para óbito

Purpose - To evaluate clinical findings and etiology of bacterial infections diagnosed in 100 consecutive heart transplantations. Methods - One hundred consecutive heart transplant patients were studied. Follow-up after heart transplantation varied from 3 to 90 (mean 25.38± SD 25.97) months. Etiology of bacterial infection was established using the Centers for Disease Control criteria. Results - Bacterial infection was the most common cause of infection after heart transplantation; diagnosis was difficult. Infection sites were skin, mucous, membranes, soft tissue, surgical scar, pericardial and pleural spaces, soft tissue around heart pacing devices, urinary tract; bacteremias and endocarditis were also found. All bacterial agents recovered were fully identified Conclusion - Bacterial infections are the most common infections in the first month after heart transplantation. They are important and also common after the treatment of the rejection episodes. Rapid diagnosis and adequate treatment are essential to prevent morbidity and death

Endocardite infecciosa em 100 pacientes submetidos a transplante cardíaco / Inectious endocarditis in 100 patients after heart transplantation

Objetivo - analisar ocorrências, agentes etiológicos, aspectos clínico e taxa de óbitos referentes à endocardite infecciosa (EI) diagnosticada em pacientes submetidos a transplante cardíaco. Métodos - cem doentes foram observados consecutivamente após transplante cardíaco. O período de seguimento variou de 3 a 90 (média 25,38 +/- 25,97) meses. O reconhecimento da EI levou em conta critérios usados no Serviço de Epidemiologia e Desenvolvimento de Qualidade do INCOR da FMUSP, tendo como bases as defiçöes estipuladas pelo Center for Disease Control. Cooperaram para estabelecer o diangóstico, fundamentalmente, hemocultura, ecocardiograma transtorácico ou esofágico e necrópsia. Resultados - houve reconhecimento de 6 casos, com 4 óbitos, estando presentes em 3 processos sistêmicos generalizados. Febre compareceu como manifestaçäo clínica habitual. Conclusäo - o número de óbitos afigurou-se elevado, tendo em conta a natureza das bactérias causadores, a associaçäo com afecçöes graves e o uso de fármacos mnodepressores. Considerou-se importante adotar adequados cuidados em relaçäo aos fatores de risco, efetuar precocemente o diagnóstico e institutir rapidamente o tratamento.