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1.
Braz. j. biol ; 84: e255080, 2024. tab, graf
Article in English | LILACS-Express | MEDLINE, LILACSEXPRESS, LILACS, VETINDEX | ID: biblio-1364503

ABSTRACT

Abstract In the current context of emerging drug-resistant fungal pathogens such as Candida albicans and Candida parapsilosis, discovery of new antifungal agents is an urgent matter. This research aimed to evaluate the antifungal potential of 2-chloro-N-phenylacetamide against fluconazole-resistant clinical strains of C. albicans and C. parapsilosis. The antifungal activity of 2-chloro-N-phenylacetamide was evaluated in vitro by the determination of the minimum inhibitory concentration (MIC), minimum fungicidal concentration (MFC), inhibition of biofilm formation and its rupture, sorbitol and ergosterol assays, and association between this molecule and common antifungal drugs, amphotericin B and fluconazole. The test product inhibited all strains of C. albicans and C. parapsilosis, with a MIC ranging from 128 to 256 µg.mL-1, and a MFC of 512-1,024 µg.mL-1. It also inhibited up to 92% of biofilm formation and rupture of up to 87% of preformed biofilm. 2-chloro-N-phenylacetamide did not promote antifungal activity through binding to cellular membrane ergosterol nor it damages the fungal cell wall. Antagonism was observed when combining this substance with amphotericin B and fluconazole. The substance exhibited significant antifungal activity by inhibiting both planktonic cells and biofilm of fluconazole-resistant strains. Its combination with other antifungals should be avoided and its mechanism of action remains to be established.


Resumo No atual contexto de patógenos fúngicos resistentes emergentes tais como Candida albicans e Candida parapsilosis, a descoberta de novos agentes antifúngicos é uma questão urgente. Esta pesquisa teve como objetivo avaliar o potencial antifúngico da 2-cloro-N-fenilacetamida contra cepas clínicas de C. albicans e C. parapsilosis resistentes a fluconazol. A atividade antifúngica da substância foi avaliada in vitro através da determinação da concentração inibitória mínima (CIM), concentração fungicida mínima (CFM), ruptura e inibição da formação de biofilme, ensaios de sorbitol e ergosterol, e associação entre esta molécula e antifúngicos comuns, anfotericina B e fluconazol. O produto teste inibiu todas as cepas de C. albicans e C. parapsilosis, com uma CIM variando de 128 a 256 µg.mL-1, e uma CFM de 512-1,024 µg.mL-1. Também inibiu até 92% da formação de biofilme e causou a ruptura de até 87% de biofilme pré-formado. A 2-cloro-N-fenilacetamida não promoveu atividade antifúngica pela ligação ao ergosterol da membrana celular fúngica, tampouco danificou a parede celular. Antagonismo foi observado ao combinar esta substância com anfotericina B e fluconazol. A substância exibiu atividade antifúngica significativa ao inibir tanto as células planctônicas quanto o biofilme das cepas resistentes ao fluconazol. Sua combinação com outros antifúngicos deve ser evitada e seu mecanismo de ação deve ser estabelecido.

2.
Braz. j. biol ; 83: e244479, 2023. tab, graf
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1285635

ABSTRACT

Abstract The objective of the present study was to analyse the bioactive compounds of the leaves of Conocarpus lancifolius (C. lancifolius). The GC-MS analysis of the hot methanolic extract of the leaves (HMEL) of C. lancifolius exhibited the bioactive compounds such as 1-(3-Methoxy-2-nitrobenzyl) iso quinoline, morphin-4-ol-6,7-dione, 1-bromo-N-methyl-, phytol, hexadecanoic acid, 2,3-dihydroxypropyl ester, 2,2':4',2"-terthiophene, ethyl iso-allocholate, caryophyllene oxide, campesterol, epiglobulol, cholestan-3-ol, 2-methylene-, (3á,5à)-, dasycarpidan-1-methanol, acetate (ester) and oleic acid, eicosyl ester. The FT-IR analysis of HMEL of C. lancifolius showed a unique peak at 3184, 2413, 1657 cm-1 representing coumaric acid, chlorogenic acid and ferulic acid. The HMEL of C. lancifolius was actively inhibiting the proliferation of breast cancer cells MCF-7 ATCC at the concentration of 72.66 ± 8.21 µg/ml as IC50 value. The HMEL of C. lancifolius also revealed a good spectrum of activity against Gram-positive and Gram-negative bacterial cultures screened in this work. The activity observed has shown more or less similar effects against screened bacteria. However, the magnitude of potentiality was significantly lesser compared to standard ciprofloxacin disc at p< 0.001 level (99% confidence intervals). Furthermore, the study demonstrating the bioactive compounds can be isolated from the leaves of C. lancifolius.


Resumo O objetivo do presente estudo foi analisar os compostos bioativos das folhas de Conocarpus lancifolius (C. lancifolius). A análise por GC-MS do extrato metanólico quente das folhas (HMEL) de C. lancifolius exibiu os compostos bioativos como 1- (3-Metoxi-2-nitrobenzil) isoquinolina, morfina-4-ol-6,7- diona, 1-bromo-N-metil-, fitol, ácido hexadecanoico, 2,3-di-hidroxipropil éster, 2,2 ': 4', 2 " - tertiofeno, isoalocolato de etil, óxido de cariofileno, campesterol, epiglobulol, colestano -3-ol, 2-metileno-, (3á, 5à) -, dasycarpidan-1-metanol, acetato (éster) e ácido oleico, éster eicosílico. A análise FT-IR de HMEL de C. lancifolius mostrou um pico único em 3184, 2413, 1657 cm-1 representando ácido cumarico, ácido clorogênico e ácido ferúlico. O HMEL de C. lancifolius inibiu ativamente a proliferação de células de câncer de mama MCF-7 ATCC na concentração de 72,66 ± 8,21 µg / ml como valor de IC50. O HMEL de C. lancifolius também revelou bom espectro de atividade contra culturas de bactérias Gram-positivas e Gram-negativas rastreadas neste trabalho. A atividade observada mostrou efeitos mais ou menos semelhantes contra bactérias rastreadas. No entanto, a magnitude da potencialidade foi significativamente menor em comparação com o disco de ciprofloxacina padrão em nível de p < 0,001 (intervalos de confiança de 99%). Além disso, o estudo demonstrando os compostos bioativos pode ser isolado das folhas de C. lancifolius.


Subject(s)
Trees , Plant Leaves , Saudi Arabia , Plant Extracts/pharmacology , Spectroscopy, Fourier Transform Infrared , Anti-Bacterial Agents/pharmacology
3.
Univ. salud ; 24(1): 85-94, ene.-abr. 2022. tab, graf
Article in Spanish | LILACS-Express | LILACS, COLNAL | ID: biblio-1361189

ABSTRACT

Introducción: La resistencia a los antimicrobianos (RAM) es un problema de salud pública que manifiesta la disminuida eficacia de estos agentes en la prevención y tratamiento de una proporción cada vez más amplia de patologías. Los actinomicetos son un grupo bacteriano importante de productores de metabolitos activos contra patógenos. Objetivo: Aislar actinomicetos del bosque tropical de Nariño, con potencial producción de metabolitos inhibitorios contra bacterias multidrogo-resistentes. Materiales y métodos: Se tomaron muestras de suelo de Bosque Tropical Húmedo de la Reserva Natural del Río Ñambí, se analizaron microbiológica y molecularmente. Se estimuló la producción in vitro de metabolitos secundarios y evaluó el efecto inhibitorio de estos extractos contra las bacterias multidrogo-resistentes Escherichia coli y Staphylococcus aureus. Resultados: Se obtuvieron 11 aislados presuntivos, se confirmó que cuatro de ellos correspondieron al género Streptomyces sp. Las pruebas de inhibición contra bacterias multidrogo-resistentes E. coli y S. aureus, permitieron verificar que el aislado P3772 fue el más eficiente en la inhibición de los patógenos. Conclusiones: Todos los actinomicetos evaluados presentan actividad antibacteriana contra al menos una de las bacterias patógenas estudiadas; destacando el aislado P3772, que inhibe a E. coli y S. aureus. Se espera caracterizar los compuestos vinculados a la actividad antibacteriana.


Introduction: Antimicrobial resistance (AR) is a public health problem that reveals the diminished efficacy of these agents in the prevention and treatment of an increasingly larger number of pathologies. Actinomycetes are an important bacterial producer group of metabolites that are active against pathogens. Objective: To isolate actinomycetes from the tropical forest of Nariño (Colombia), which have the potential to produce inhibitory metabolites against multi-drug resistant bacteria. Materials and methods: Soil samples were taken from the Humid Tropical Forest of the Río Ńambí Natural Reserve and analyzed through microbiological and molecular assays. In vitro production of secondary metabolites was first stimulated, followed by the assessment of the inhibitory effect of these extracts against multi-drug resistant Escherichia coli and Staphylococcus aureus. Results: 11 presumptive isolates were obtained, confirming that four of them corresponded to the Streptomyces sp. genus. The bacterial isolate P3772 was identified as the one with the highest inhibitory effect against multi-drug resistant E. coli and S. aureus. Conclusions: All the actinomycetes evaluated presented antibacterial activity. The isolate P3772 stands out, which inhibited both E. coli and S. aureus. The compounds associated with this antibacterial activity will be characterized in future studies.


Subject(s)
Humans , Male , Female , Bacteria , Anti-Infective Agents , Staphylococcus aureus , Actinobacteria , Drug Resistance, Bacterial , Escherichia coli , Anti-Bacterial Agents
4.
ABCS health sci ; 47: e022203, 06 abr. 2022. tab, graf
Article in English | LILACS | ID: biblio-1363538

ABSTRACT

INTRODUCTION: Contamination of cell phones can contribute to the dissemination of pathogens in the community and/or hospital environment. OBJECTIVE: To characterize Staphylococcus aureus strains isolated from cell phones of university students. METHODS: Samples were collected from 100 cell phones. Detection of genes associated with virulence factors such as biofilm formation (icaA and icaD), enterotoxins production (SEA, SEB, SEC, and SED), and resistance to methicillin (mecA and mecC) was performed in S. aureus isolates by PCR. Typing mecA gene performed by multiplex PCR. Susceptibility to antimicrobials and biofilm formation rate also evaluated by using disk diffusion test and crystal violet staining. RESULTS: S. aureus was present in 40% of the total samples and about 70% of them belonged to Nursing students. Of the isolates, 85% presented resistance to penicillin and 50% were classified as moderate biofilm producers. In addition, 92.5% of isolates contained the gene icaA and 60% of the gene icaD. Approximately 25% of the isolates presented the mecA gene. Typing of the mecA gene showed the presence of staphylococcal chromosome cassette SCCmec I and c III respectively in 20% and 10% of the isolates. 70% of the samples could not be typed by the technique. Regarding the enterotoxins, the most prevalent gene was SEA (30%) followed by the SEC gene (2.5%). The presence of SED and SEB genes not observed in any of the isolates. CONCLUSION: The cleaning and periodic disinfection of cell phones can contribute to the reduction of the risk of nosocomial infection.


INTRODUÇÃO: A contaminação de celulares pode contribuir para a disseminação de patógenos na comunidade e/ou ambiente hospitalar. OBJETIVO: Caracterizar cepas de Staphylococcus aureus de telefones celulares de estudantes universitários. MÉTODOS: Foram coletadas amostras de 100 telefones celulares. Detecção de genes associados a fatores de virulência quanto a: formação de biofilme (icaA e icaD), produção de enterotoxinas (SEA, SEB, SEC e SED) e resistência à meticilina (mecA e mecC) foi realizada em isolados de S. aureus por PCR. A Tipagem do gene mecA foi realizada por PCR multiplex. A susceptibilidade a antimicrobianos e a taxa de formação de biofilme pelo teste de difusão em disco e coloração com cristal violeta. RESULTADOS: S. aureus esteve presente em 40% do total de amostras, destas, 70% pertenciam a estudantes do curso de enfermagem. Dos isolados, 85% apresentaram resistência à penicilina e 50% foram classificados com moderada formação de biofilme. Além disso, 92,5% dos isolados continham o gene icaA e 60% o gene icaD. Aproximadamente 25% dos isolados apresentaram o gene mecA. A tipagem do gene mecA mostrou a presença do cassete cromossômico estafilocócico SSCmec I e III em respectivamente 20% e 10% dos isolados. 70% das amostras não puderam ser identificadas pela técnica. Das enterotoxinas, o gene mais prevalente foi o SEA (30%), seguido pelo gene SEC (2.5%). A presença dos genes SED e SEB não foi observada nos isolados. CONCLUSÃO: A limpeza e desinfecção periódica dos telefones celulares podem contribuir para a redução do risco de infecção nosocomiais.


Subject(s)
Students, Health Occupations , Universities , Cell Phone , Methicillin-Resistant Staphylococcus aureus , Virulence , Drug Resistance, Microbial , Biofilms , Enterotoxins
5.
Medicina UPB ; 41(1): 51-60, mar. 2022. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1362696

ABSTRACT

Helicobacter pylori es un carcinógeno tipo I resistente a múltiples antibióticos y con alta prioridad en salud pública. La infección por este microorganismo está influenciada por una interacción compleja entre la genética del huésped, el entorno y múltiples factores de virulencia de la cepa infectante. Afecta al 50 % de la población mundial, provocando afecciones gastroduodenales graves, la mayoría de forma asintomática. El 20 % de los individuos con H. pylori pueden desarrollar a través del tiempo lesiones gástricas preneoplásicas y el 2 % de ellos un cáncer gástrico. Las manifestaciones clínicas gastrointestinales y extragastrointestinales están asociadas a su virulencia y a la respuesta del sistema inmunológico con la liberación de citosinas proinflamatorias, tales como TNF-alfa, IL-6, IL-10 e IL-8, causantes de inflamación aguda y crónica. Múltiples factores de virulencia han sido estudiados como el gen A asociado a la citotoxina (CagA) y la citotoxina vacuolante (VacA), los cuales juegan un rol importante en la aparición del cáncer gástrico. Dada la resistencia cada vez mayor a los antibióticos utilizados, las líneas de estudio en el futuro inmediato deben estar encaminadas en establecer la utilidad de los nuevos antibióticos y la determinación de profagos colombianos en todo el país. Esta revisión tiene como objetivo hacer una puesta al día sobre las características del H. pylori, los mecanismos patogénicos, genes de virulencia, su asociación con el mayor riesgo de cáncer gástrico, farmacorresistencia microbiana y su erradicación.


Helicobacter pylori is recognized as a class I carcinogen resistant to multiple antibiotics and with high priority in public health. The infection caused by this microorganism is influenced by a complex interaction between host genetics, environment, and multiple virulence factors of the infecting strain. It affects 50% of the world population, causing severe gastroduodenal conditions, most of them asymptomatic. Through time, 20% of individuals with H. pylori may develop preneoplastic gastric lesions and 2% of them develop gastric cancer. The gastrointestinal and extra-gastrointestinal clinical manifestations are associated with its virulence and the response of the immune system with the release of pro-inflammatory cytokines, such as TNF-alpha, IL-6, IL-10 and IL-8, which cause acute and chronic inflammation. Multiple virulence factors have been studied, such as cytotoxin-associated gene A (CagA) and vacuolating cytotoxin A (VacA), which play an important role in the development of gastric cancer. Due to the increasing antibiotics resistance, the research in the immediate future should be aimed at establishing the usefulness of the new antibiotics and the determination of Colombian prophages throughout the country. This paper aims to update the characteristics of H. pylori, its pathogenic mechanisms, virulence genes, its association with the increased risk of gastric cancer, microbial drug resistance, and eradication.


Helicobacter pylorié um carcinógeno tipo I resistente a múltiplos antibióticos e com alta prioridade na saúde pública. A infecção por este microrganismo está influenciada por uma interação complexa entre a genética do hospede, o entorno e múltiplos fatores de virulência da cepa infectante. Afeta a 50% da população mundial, provocando afeções gastroduodenais graves, a maioria de forma assintomática. 20% dos indivíduos com H. pylori podem desenvolver através do tempo lesões gástricas pré-neoplásicas e 2% deles um câncer gástrico. As manifestações clínicas gastrointestinais e extragastrointestinais estão associadas à sua virulência e à resposta do sistema imunológico com a liberação de citocinas pró-inflamatórias, tais como TNF-alfa, IL-6, IL-10 e IL-8, causantes de inflamação aguda e crónica. Múltiplos fatores de virulência hão sido estudados como o gene. A associado à citotoxina (CagA) e a citotoxina vacuolante (VacA), os quais jogam um papel importante no aparecimento do câncer gástrico. Dada a resistência cada vez maior aos antibióticos utilizados, as linhas de estudo no futuro imediato devem estar encaminhadas em estabelecer a utilidade dos novos antibióticos e a determinaçãode profagos colombianos em todo o país. Esta revisão tem como objetivo fazer uma atualização sobre as características do H. pylori, os mecanismos patogénicos, genes de virulência, sua associação com o maior risco de câncer gástrico, farmacorresistência microbiana e sua erradicação.


Subject(s)
Humans , Helicobacter pylori , Drug Resistance , Carcinogens , Virulence Factors , Disease Eradication , Immune System , Anti-Bacterial Agents
6.
Rev. Eugenio Espejo ; 16(1): 71-80, 20220111.
Article in Spanish | LILACS | ID: biblio-1353012

ABSTRACT

La tuberculosis continúa siendo un problema de salud pública. Al respecto, se realizó un estudio no experimental de corte transversal, con el objetivo de caracterizar clínica y epidemiológica-mente el estado de la TB resistente a medicamentos de primera línea en la ciudad de Durán, desde enero 2015 hasta diciembre 2019. Los datos incluidos en los documentos de la matriz del programa de tuberculosis resistente. De 1111 casos nuevos de tuberculosis reportados en el cantón Durán durante el período estudiado, 45 de estos presentaron resistencia a medicamentos de primera línea. El 88,89% tuvo resistencia a rifampicina, el 33,33% de los pacientes se dispen-sarizaron en 2019. Los valores de chi cuadrado de Pearson no mostraron asociación estadística-mente significativa entre las variables investigadas (p>0,05). Entre los involucrados predominó el grupo de edades de 20 a 39 años, el sexo masculino, la tuberculosis pulmonar, infectados con VIH/sida, resistencia clasificada como primaria, los que abandonaron el seguimiento al trata-miento y la no manifestación de reacciones adversas a los medicamentos. No se observó mortali-dad entre los casos nuevos, predominando entre aquellos con recaída, el género masculino y los que tuvieron tuberculosis extrapulmonar.


Tuberculosis is a disease that continues to be a public health problem. In this regard, a non-expe-rimental cross-sectional study was carried out to characterize clinically and epidemiologically the status of TB resistant to first-line drugs in the city of Durán, from January 2015 to December 2019. The data included in the resistant tuberculosis program matrix documents. 1111 new cases of tuberculosis were reported in the Duran canton during the study period, 45 of these ones presented resistance to first-line drugs. 88.89% had rifampicin resistance, 33.33% of the patients were dispensed in 2019. Pearson's chi-square values did not show a statistically significant asso-ciation between the investigated variables (p> 0.05). Among the study population, it was predo-minated the age group between 20 and 39, male sex, pulmonary tuberculosis, infected with HIV / AIDS, resistance classified as primary, those who abandoned the follow-up to treatment and the non-manifestation of adverse drug reactions. No mortality was observed among new cases, predominantly among those ones with relapse, the male gender and those ones who had extra-pulmonary tuberculosis


Subject(s)
Humans , Male , Female , Adult , Patients , Tuberculosis , Drug Resistance , Therapeutics , Epidemiologic Factors , HIV
7.
Journal of Clinical Hepatology ; (12): 372-380, 2022.
Article in Chinese | WPRIM | ID: wpr-920887

ABSTRACT

Objective Drug resistance is the main cause of chemotherapy failure in hepatocellular carcinoma (HCC), and thioredoxin reductase 1 (TXNRD1), as a major influencing factor for reactive oxygen species (ROS) metabolism, has been proven to be associated with the poor prognosis of patients with HCC. This study aims to explore the role of TXNRD1 in the mechanism of multidrug resistance in HCC. Methods BEL/FU cells in BEL-7402 cell line were selected as the multidrug-resistant cell line. The siRNA was used for the intervention of TXNRD1 expression; quantitative real-time PCR and Western blotting were used to measure the expression of TXNRD1; CCK-8 assay and flow cytometry were used to evaluate the effect of TXNRD1 on hepatocyte ROS accumulation, resistance to 5-fluorouracil (5-Fu) and doxorubicin (DOX), and apoptosis in vitro; a xenograft tumor model was established to investigate the effect of auranofin (AUR) on drug resistance in vivo. The two-independent-samples t test was used for comparison of continuous data between two groups. Results As a multidrug-resistant HCC cell line, BEL/Fu showed high mRNA and protein expression levels of TXNRD1 (both P < 0.05). Compared with 5-Fu or DOX treatment alone, the TXNRD1 inhibitor AUR combined with 5-Fu or DOX had had a significant reduction in the number of colony formation ( P < 0.01) and a significant increase in apoptosis ratio ( P < 0.001). The ROS scavenger N-acetylcysteine (NAC) significantly weakened the effect of TXNRD1 knockdown by siRNA on the drug resistance of BEL/Fu cells, and the application of NAC effectively reduced the apoptosis ratio of cells after siRNA interference ( P < 0.001). Animal experiments also confirmed that compared with the nude mice treated with 5-Fu alone, the nude mice treated with 5-Fu and AUR had a significantly lower tumor mass ( P < 0.001) and a significantly smaller tumor volume ( P < 0.001). Conclusion TXNRD1 plays an important role in the drug resistance of HCC, and inhibition of its level in cells can effectively improve drug resistance. As a TXNRD1 inhibitor, AUR has great application prospects in the multimodality therapy for HCC.

8.
Journal of Clinical Hepatology ; (12): 328-333, 2022.
Article in Chinese | WPRIM | ID: wpr-920879

ABSTRACT

Objective To investigate the difference in naturally occurring resistance-associated variants (RAVs) between the patients with HIV/HCV co-infection and those with HCV infection alone by detecting the drug resistance loci associated with HCV NS3/4A protease and NS5A inhibitors. Methods A total of 246 patients with HIV/HCV co-infection or HCV infection alone who were hospitalized or attended the outpatient service in Guangzhou Eighth People's Hospital, Guangzhou Medical University, from January 2016 to January 2020 were enrolled in this study. Serum samples were collected and next-generation sequencing (Illumina platform, PE250) was used for sequencing. The two groups of patients were compared in terms of RAVs associated with NS3/4A protease and NS5A inhibitors approved in China, and the drugs for analysis included asunaprevir/daclatasvir (ASV/DCV) and elbasvir/grazoprevir (EBR/GZR) for HCV genotype 1b and glecaprevir/pibrentasvir (GLE/PIB) for pan-genotypes. The t -test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Fisher's exact test was used for comparison of categorical data between two groups. Results Among the 246 serum samples included in this study, 239 samples (97.2%) were successfully amplified by PCR and sequenced, with 102 samples from the patients with HIV/HCV co-infection and 137 from the patients with HCV infection alone. The analysis of RAVs associated with ASV/DCV and EBR/GZR showed that Y56F, Q80K/L, and S122N/R/T associated with ASV and GZR and L31M and Y93H associated with DCV and EBR were observed in patients with HIV/HCV (genotype 1b) co-infection or HCV (genotype 1b) infection alone; 2 patients with HIV/HCV co-infection had the RAVs of Y56F+Y93H associated with EBR/GZR, and 2 with HCV infection alone had the RAVs of Q80L+L31M and Y56F+Y93H, respectively, associated with EBR/GZR, with no significant difference in RAVs between the two groups (both P > 0.05). The analysis of RAVs associated with GLE/PIB for pan-genotypes showed that 3 patients with PIB-associated Y93H RAV were observed among the patients with HCV genotype 3a infection, among whom 2 had HIV/HCV co-infection and 1 had HCV infection alone ( P =0.590), and in addition, no RAVs associated with GLE/PIB were observed. Conclusion There is no significant difference in naturally occurring RAVs associated with HCV NS3/4A protease and NS5A inhibitors between the patients with HIV/HCV co-infection and those with HCV infection alone.

9.
Organ Transplantation ; (6): 225-2022.
Article in Chinese | WPRIM | ID: wpr-920853

ABSTRACT

Objective To analyze the distribution characteristics and drug resistance of pathogens in infected donors from organ donation after citizen's death. Methods Clinical data of 465 potential donors from organ donation after citizen's death were retrospectively analyzed. The airway secretion, urine and blood samples of all donors were cultured. The infection rate of the donors, the source and composition ratio of pathogens were summarized. The drug resistance of main Gram-negative and Gram-positive pathogens was analyzed. Results Among 465 donors, 330 cases were infected and the infection rate was 71.0%. Among the positive culture samples of all donors, lower respiratory tract samples accounted for 63.8%(292/458), 18.6%(85/458) for blood samples and 17.7%(81/458) for urine samples. A total of 512 pathogens were isolated, including 75.0%(384/512) of Gram-negative pathogens, 18.2%(93/512) of Gram-positive pathogens followed by 6.8%(35/512) of fungi. Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii were the most common Gram-negative pathogens. Klebsiella pneumoniae was sensitive to quinolones, compound preparations containing β-lactamase inhibitor (piperacillin-tazobactam, cefoperazone sodium-sulbactam sodium) and carbapenem antibiotics, whereas less sensitive to cephalosporins. Pseudomonas aeruginosa was sensitive to β-lactams, quinolones and aminoglycosides. Acinetobacter baumannii was sensitive to polymyxin, tigecycline and amikacin, whereas resistant to the other antibiotics. No Gram-positive pathogens was resistant to vancomycin, linezolid and teicoplanin. Staphylococcus aureus and coagulase-negative staphylococci were the most commonly isolated Gram-positive pathogens, which yielded resistance rates of 36% and 87% to oxacillin sodium, and were generally resistant to penicillin and erythromycin. The resistance rate of Enterococcus faecalis to quinolones and erythromycin exceeded 90%, and 55% for high-concentration gentamicin. Conclusions The infection rate of organ donors from organ donation after citizen's death is relatively high, and the main infection site is lung. Gram-negative pathogens are the most commonly isolated strains, and certain strains tend to exhibit multiple drug resistance.

10.
Acta Paul. Enferm. (Online) ; 35: eAPE03751, 2022. tab
Article in Portuguese | LILACS, BDENF | ID: biblio-1364223

ABSTRACT

Resumo Objetivo Caracterizar os microrganismos e sua suscetibilidade antimicrobiana em uroculturas de idosos residentes de uma instituição de longa permanência. Métodos Estudo observacional transversal com 116 indivíduos de uma Instituição de Longa Permanência para Idosos de um município do sul da Bahia. O estudo foi aprovado por Comitê de Ética em Pesquisa e utilizou-se Termo de Consentimento Livre e Esclarecido. Foram realizadas coleta e análise laboratorial de urina tipo I e urocultura. Realizaram-se testes de sensibilidade a antimicrobianos conforme os critérios do European Committee on Antimicrobial Susceptibility Testing. Para o diagnóstico de infecção do trato urinário, foram utilizados os critérios de McGeer. A análise de dados se deu por estatística descritiva, com frequências absolutas e relativas. Resultados A prevalência de infecção do trato urinário foi de 33,62%, com predominância no sexo feminino e idade acima de 80 anos. Os uropatógenos foram: 69,2% Escherichia coli, 20,6% Klebsiella pneumoniae e 5,1% Providencia stuartii e Acinetobacter baumannii. As cepas de E. coli apresentaram suscetibilidade para a maior parte dos antimicrobianos; já nas de K. pneumoniae, a suscetibilidade foi variável. P. stuartii e A. baumannii não apresentaram resistência a carbapenêmicos e aos betalactâmicos aztreonam e piperacilina associados a tazobactam. Conclusão As cepas mais prevalentes e o perfil de suscetibilidade seguiram padrão próximo ao hospitalar, o que implica a necessidade de a instituição promover melhores estratégias de controle de infecção e envolver a equipe de enfermagem no gerenciamento dos casos e na qualificação da prescrição antimicrobiana, para reduzir a resistência bacteriana e efeitos adversos nos idosos.


Resumen Objetivo Caracterizar los microorganismos y su susceptibilidad antimicrobiana en urocultivos de adultos mayores residentes en una institución de larga estadía. Métodos Estudio observacional transversal con 116 individuos de una institución de larga estadía para adultos mayores de un municipio del sur del estado de Bahia. El estudio fue aprobado por el Comité de Ética de Investigación y se utilizó Consentimiento Informado. Se obtuvieron muestras de orina, con las cuales se realizó análisis de laboratorio tipo I y urocultivo. Se realizaron pruebas de sensibilidad a antimicrobianos según los criterios del European Committee on Antimicrobial Susceptibility Testing. Para el diagnóstico de infección del tracto urinario, se utilizaron los criterios de McGeer. El análisis de datos se obtuvo mediante estadística descriptiva, con frecuencias absolutas y relativas. Resultados La prevalencia de infección del tracto urinario fue del 33,62 %, con predominancia del sexo femenino y edad superior a 80 años. Los uropatógenos fueron: 69,2 % Escherichia coli, 20,6 % Klebsiella pneumoniae y 5,1 % Providencia stuartii y Acinetobacter baumannii. Las cepas de E. coli presentaron susceptibilidad en la mayor parte de los antimicrobianos, en las de K. pneumoniae, la susceptibilidad fue variable. P. stuartii y A. baumannii no presentaron resistencia a carbapenémicos ni a los betalactámicos aztreonam y piperacilina asociados a tazobactam. Conclusión Las cepas más prevalentes y el perfil de susceptibilidad presentaron un patrón parecido al hospitalario, lo que implica la necesidad de que la institución promueva mejores estrategias de control de infecciones e involucre al equipo de enfermería en la gestión de los casos y en la cualificación de la prescripción antimicrobiana para reducir la resistencia bacteriana y los efectos adversos en los adultos mayores.


Resumo Objetivo Caracterizar os microrganismos e sua suscetibilidade antimicrobiana em uroculturas de idosos residentes de uma instituição de longa permanência. Métodos Estudo observacional transversal com 116 indivíduos de uma Instituição de Longa Permanência para Idosos de um município do sul da Bahia. O estudo foi aprovado por Comitê de Ética em Pesquisa e utilizou-se Termo de Consentimento Livre e Esclarecido. Foram realizadas coleta e análise laboratorial de urina tipo I e urocultura. Realizaram-se testes de sensibilidade a antimicrobianos conforme os critérios do European Committee on Antimicrobial Susceptibility Testing. Para o diagnóstico de infecção do trato urinário, foram utilizados os critérios de McGeer. A análise de dados se deu por estatística descritiva, com frequências absolutas e relativas. Resultados A prevalência de infecção do trato urinário foi de 33,62%, com predominância no sexo feminino e idade acima de 80 anos. Os uropatógenos foram: 69,2% Escherichia coli, 20,6% Klebsiella pneumoniae e 5,1% Providencia stuartii e Acinetobacter baumannii. As cepas de E. coli apresentaram suscetibilidade para a maior parte dos antimicrobianos; já nas de K. pneumoniae, a suscetibilidade foi variável. P. stuartii e A. baumannii não apresentaram resistência a carbapenêmicos e aos betalactâmicos aztreonam e piperacilina associados a tazobactam. Conclusão As cepas mais prevalentes e o perfil de suscetibilidade seguiram padrão próximo ao hospitalar, o que implica a necessidade de a instituição promover melhores estratégias de controle de infecção e envolver a equipe de enfermagem no gerenciamento dos casos e na qualificação da prescrição antimicrobiana, para reduzir a resistência bacteriana e efeitos adversos nos idosos.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Urinary Tract Infections/epidemiology , Drug Resistance, Microbial , Drug Resistance, Bacterial , Cross-Sectional Studies , Infection Control , Observational Studies as Topic , Homes for the Aged
11.
Braz. j. biol ; 82: e234471, 2022. tab, graf
Article in English | LILACS | ID: biblio-1153460

ABSTRACT

Abstract High doses of antibiotics used in hospitals can affect the microbial composition of sewers, selecting resistant bacteria. In this sense, we evaluated the antibiotic resistance profile and the multiresistant phenotype of bacteria isolated in sewage from a tertiary hospital in the interior São Paulo state, Brazil. For bacteria isolation, 10 µL of sewage samples were sown in selective culture media and the isolates were identified using VITEK-2 automatized system. The antibiotic sensitivity test was performed by disk diffusion. High percentages of resistance were found for amoxicillin, ampicillin, ceftazidime, clindamycin, vancomycin and the multidrug-resistant phenotype (MDR) was attributed to 60.7% of the isolates. Our results show bacteria classified as critical/high priority by WHO List of Priority Pathogens (Enterococcus and Staphylococcus aureus resistant to vancomycin and Enterobacteriaceae resistant to carbapenems) in hospital sewage. Therefore, the implementation of disinfection technologies for hospital sewage would reduce the bacterial load in the sewage that will reach urban wastewater treatment plants, minimizing superficial water contamination and bacterial resistance spread in the environment.


Resumo Altas doses de antibióticos utilizados em hospitais podem afetar a composição microbiana dos esgotos, selecionando bactérias resistentes. Nesse sentido, avaliamos o perfil de resistência a antibióticos e o fenótipo multirresistente de bactérias isoladas em esgoto de um hospital terciário no interior do estado de São Paulo, Brasil. Para o isolamento de bactérias, foram semeados 10 µL das amostras de esgoto em meios de cultura seletivos e os isolados foram identificados usando o sistema automatizado VITEK-2. O teste de sensibilidade aos antibióticos foi realizado por disco-difusão em ágar. Elevadas porcentagens de resistência foram encontradas para amoxicilina, ampicilina, ceftazidima, clindamicina, vancomicina e o fenótipo multirresistente (MDR) foi atribuído a 60,7% dos isolados. Nossos resultados mostram bactérias classificadas como prioridade crítica/alta pela Lista de Patógenos Prioritários da OMS (Enterococcus e Staphylococcus aureus resistentes à vancomicina e Enterobacteriaceae resistentes aos carbapenêmicos) no esgoto hospitalar. Sendo assim, implementação de tecnologias de desinfecção do esgoto hospitalar reduziriam a carga bacteriana no esgoto que chegará às estações de tratamento de esgoto urbanas, minimizando a contaminação dos ecossistemas hídricos receptores e a disseminação da resistência bacteriana no ambiente.


Subject(s)
Sewage , Bacteria/genetics , Phenotype , Brazil , Microbial Sensitivity Tests , Tertiary Care Centers
12.
Braz. j. infect. dis ; 26(1): 102332, 2022. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1364546

ABSTRACT

Abstract Tuberculosis (TB), caused by Mycobacterium tuberculosis (MTB), is one of the top 10 causes of death worldwide. Drug-resistant tuberculosis (DR-TB) poses a major threat to the World Health Organization's "End TB" strategy which has defined its target as the year 2035. In 2019, there were close to 0.5 million cases of DRTB, of which 78% were resistant to multiple TB drugs. The traditional culture-based drug susceptibility test (DST - the current gold standard) often takes multiple weeks and the necessary laboratory facilities are not readily available in low-income countries. Whole genome sequencing (WGS) technology is rapidly becoming an important tool in clinical and research applications including transmission detection or prediction of DR-TB. For the latter, many tools have recently been developed using curated database(s) of known resistance conferring mutations. However, documenting all the mutations and their effect is a time-taking and a continuous process and therefore Machine Learning (ML) techniques can be useful for predicting the presence of DR-TB based on WGS data. This can pave the way to an earlier detection of drug resistance and consequently more efficient treatment when compared to the traditional DST.

13.
Mem. Inst. Oswaldo Cruz ; 117: e210401, 2022. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1365153

ABSTRACT

Chagas disease and leishmaniasis are neglected tropical diseases caused by the protozoan parasites Trypanosoma cruzi and Leishmania spp., respectively. They are among the most important parasitic diseases, affecting millions of people worldwide, being a considerable global challenge. However, there is no human vaccine available against T. cruzi and Leishmania infections, and their control is based mainly on chemotherapy. Treatments for Chagas disease and leishmaniasis have multiple limitations, mainly due to the high toxicity of the available drugs, long-term treatment protocols, and the occurrence of drug-resistant parasite strains. In the case of Chagas disease, there is still the problem of low cure rates in the chronic stage of the disease. Therefore, new therapeutic agents and novel targets for drug development are urgently needed. Antioxidant defence in Trypanosomatidae is a potential target for chemotherapy because the organisms present a unique mechanism for trypanothione-dependent detoxification of peroxides, which differs from that found in vertebrates. Cellular thiol redox homeostasis is maintained by the biosynthesis and reduction of trypanothione, involving different enzymes that act in concert. This study provides an overview of the antioxidant defence focusing on iron superoxide dismutase A, tryparedoxin peroxidase, and ascorbate peroxidase and how the enzymes play an important role in the defence against oxidative stress and their involvement in drug resistance mechanisms in T. cruzi and Leishmania spp.

14.
Rev. Ciênc. Méd. Biol. (Impr.) ; 20(3): 413-417, dez 20, 2021. fig, tab
Article in Portuguese | LILACS | ID: biblio-1354260

ABSTRACT

Introdução: a meningite bacteriana em equinos é uma enfermidade frequente em animais jovens. Streptococcus spp., Staphylococcus aureus e Escherichia coli são as bactérias mais comumente isoladas nesses casos. Apesar da bactéria Providencia rettgeri já ter sido isolada em casos de meningite humana e de crocodilo, não há relatos de seu isolamento em equinos. Objetivo: relatar o isolamento e a identificação da bactéria P. rettgeri de um potro com sintomas neurológicos e avaliar o perfil de sensibilidade a antibióticos deste isolado. Metodologia: o isolamento foi realizado a partir do líquido cefalorraquidiano do potro, por meio de cultivo em meio ágar chocolate. Após isolamento, as colônias formadas foram identificadas por equipamento Biotyper, baseado em espectrometria de massa. O perfil de sensibilidade foi definido por teste de difusão em discos, seguindo metodologia relatada pelo CLSI M2-A8 em 2003, sendo a bactéria classificada como resistente, padrão indeterminado ou sensível aos antibióticos, de acordo com o descrito pelo EUCAST em 2021. Resultados: este é o primeiro relato do isolamento de P. rettgeri como agente etiológico de meningite em potro. Dos 15 antibióticos testados, a bactéria foi resistente a 9, sensível a 5 e com padrão indeterminado a 1 antibiótico. Conclusão: nossos resultados indicam que P. rettgeri deve ser considerada entre possíveis agentes etiológicos de quadros neurológicos em equinos e que testes de sensibilidade a antibiótico são fundamentais, uma vez que essa bactéria já apresenta resistência a diversos antibióticos disponíveis comercialmente.


Introduction: Bacterial meningitis in horses is a frequent disease in young animals. Streptococcus spp., Staphylococcus aureus and Escherichia coli are the most commonly isolated bacteria in these cases. Although Providencia rettgeri bacterium has already been isolated in cases of human and crocodile meningitis, there are no reports of its isolation in cases of meningitis in horses. Objective: to report isolation and identification of the P. rettgeri bacteria from a foal with neurological symptoms and to assess antibiotic sensitivity profile in isolate of it. Methods: isolation was performed from the foal's cerebrospinal fluid, through cultivation in chocolate agar medium. After isolation, formed colonies were identified by Biotyper equipment, based on mass spectrometry. Sensitivity profile was verified by disk diffusion test, according to methodology that was reported by CLSI M2-A8 in 2003, which classified bacteria as resistant, indeterminate pattern or sensitive to antibiotics, as described by EUCAST in 2021. Results: this is the first report on isolation of P. rettgeri as an etiologic agent of meningitis in foals. Among 15 antibiotics that were tested, results showed bacteria resistence to 9 antibiotics, bacteria sensitivity to 5, but undetermined pattern to 1 antibiotic. Conclusion: results indicate that P. rettgeri shall be considered among potential etiologic agents of neurological conditions in horses and that antibiotic sensitivity tests are essential, since this type of bacterium is already resistant to several commercially available antibiotics.


Subject(s)
Animals , Microbial Sensitivity Tests , Equidae , Meningitis , Anti-Infective Agents , Staphylococcus aureus , Bacteria , Escherichia coli , Anti-Bacterial Agents , Noxae
15.
NOVA publ. cient ; 19(37): 57-69, jul.-dic. 2021. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1365191

ABSTRACT

Resumen Objetivo. Describir la frecuencia de los microorganismos y la resistencia antibiótica de bacterias aisladas en hemocultivos de pacientes con Bacteremia, en un hospital universitario de Colombia. Métodos. Se desarrolló un estudio observacional, descriptivo y de corte transversal, en individuos mayores de 18 años, en donde se describió los hemocultivos positivos, aislados en todos los servicios del Hospital Universitario del Caribe. Resultados. De los 211 hemocultivos analizados, el 53,1% fueron hombres. Los microorganismos Gram positivos corresponden a 49,8%, con una alta frecuencia de S. aureus en un 16,1%. De los microorganismos Gram negativos fue aislado E.coli en un 18%. La resistencia a vancomicina se estableció en 4,4%. La K. pneumoniae presentó una resistencia a meropenem en un 15,3% de los casos. E.coli, P. aeruginosa y E.cloacae son sensibles a carbapénicos. Así en nuestro estudio las bacterias más frecuentemente aisladas en los hemocultivos fueron predominantemente Gram negativos, con resistencia a carbapénicos para algunas cepas de K. Pneumoniae.


Abstract Objective. To describe the frequency of microorganisms and the antibiotic resistance of isolated bacteria in blood cultures of patients with bacteremia, in a university hospital in Colombia. Methods. An observational, descriptive, and cross-sectional study was developed in individuals older than 18 years, where the positive blood cultures were described, isolated in all the services of the University Hospital of the Caribbean. Results. Of the 211 blood cultures analyzed, 53.1% were men. The Gram-positive microorganisms correspond to 49.8%, with a high frequency of S. aureus in 16.1%. Of the Gram negative microorganisms, E.coli was isolated by 18%. Vancomycin resistance was established at 4.4%. K. pneumoniae showed resistance to meropenem in 15.3% of cases. E.coli, P. aeruginosa and E. cloacae are sensitive to carbapenes. Thus, in our study, the bacteria most frequently isolated in the blood cultures were predominantly Gram negative, with resistance to carbapenes for some strains of K. pneumoniae.

16.
Rev. med. Risaralda ; 27(2): 102-125, jul.-dic. 2021. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1365898

ABSTRACT

Resumen La sepsis neonatal constituye una de las principales causas de mortalidad neonatal en los países en desarrollo. Los neonatos, en particular los prematuros, tienen un mayor riesgo de infecciones bacterianas, por lo que el manejo con antibióticos constituye la terapia más frecuente en la Unidad de Cuidado Intensivo Neonatal (UCIN), estimándose en hasta un 70%. La presentación clínica de la sepsis neonatal es inespecífica en muchas ocasiones, lo que hace que la antibioticoterapia empírica se inicie tempranamente para evitar consecuencias deletéreas para los pacientes; su inespecificidad la caracteriza como un reto diagnóstico, por lo que diferentes autores han diseñado estrategias para determinar neonatos candidatos a terapia antimicrobiana. La microbiología permanece en contacto estrecho con la clínica ya que conocer los gérmenes frecuentemente asociados a la sepsis neonatal ayuda a determinar el espectro antibiótico a usar. De igual forma, el conocimiento de la farmacología antibiótica es clave puesto que el tratamiento antibiótico no es inocuo y puede asociarse a aumento de morbilidad o mortalidad. El tiempo de evolución y los factores de riesgo maternos están asociados a los gérmenes responsables esperados, ya descritos por múltiples estudios descriptivos a nivel mundial. El uso indiscriminado de antibióticos de amplio espectro para el manejo de infecciones en los recién nacidos ha generado un aumento en la resistencia antibiótica, lo que a su vez lleva a tasas más altas de fallo terapéutico con el uso de las terapias antibióticas empíricas. A razón de lo anterior, los Programas de Vigilancia de Uso de Antibióticos juegan un papel determinante para monitorear el cambio en la resistencia a nivel local para ajustar y homogeneizar la práctica médica que logre regular el uso de antibióticos y mitigar la emergente resistencia bacteriana.


Abstract Neonatal sepsis constitutes one of the main causes of neonatal mortality in developing countries. Newborns, particularly premature newborns, have a higher risk of bacterial infections that result in frequent administration of antibiotics in the Neonatal Intensive Care Units (NICU), which is estimated to be as high as 70%. The clinical presentation of neonatal sepsis is nonspecific, prompting the early use of empirical antibiotic prescription to avoid adverse consequences in the patients. Its non-specificity characterizes it as a challenging diagnostic, this aspect led several authors to design strategies to determine which newborns are true candidates for antimicrobial therapy. Microbiology is closely linked to clinical practice. Thus, knowing the most frequent bacteria associated with neonatal sepsis will be closely related to the antibiotic spectrum that should be used to treat it. Furthermore, knowledge on basic pharmacology is key inasmuch as the antimicrobial treatment is not innocuous and can be related to an increase in mortality and morbidity. Clinical course and maternal risk factors are associated with the expected responsible germs that are already described in multiple descriptive studies worldwide. Indiscriminate use of broad-spectrum antibiotics for the management of newborn infections is leading to antibiotic resistance increase. At the same time, this is related to even higher rates of therapeutic failure with empiric antimicrobial treatment. Based on this, Antimicrobial Stewardship Programs play a determinant role to monitor the changes in local resistance to adjust and homogenize medical practice to regulate the use of antibiotics and mitigate the emergent and threatening antimicrobial bacterial resistance.

17.
Rev. peru. med. exp. salud publica ; 38(4): 615-620, oct.-dic. 2021. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1365919

ABSTRACT

RESUMEN El objetivo del estudio fue identificar molecularmente los genes de virulencia y resistencia a macrólidos en aislamientos clínicos de Streptococcus agalactiae (EGB), recuperados en 2019 a partir de secreción vaginal (n=9) y orina (n=22), en dos establecimientos de salud de Lima. La identificación y susceptibilidad antimicrobiana se determinaron por el sistema automatizado Vitek® 2, se confirmó la identificación fenotípicamente; la resistencia a macrólidos por el método D-test; la identificación de genes de virulencia (lmb, bca y rib) y de resistencia a macrólidos (ermB, ermTR y mefA) por reacción en cadena de la polimerasa (PCR). El fenotipo y genotipo de resistencia a macrólidos predominante fue cMLSb (12/31) y ermB (11/31), y el gen de virulencia más frecuente fue lmb (23/31). Todos fueron sensibles a penicilina, ampicilina y vancomicina. Estos hallazgos muestran la necesidad de implementar estudios de epidemiología molecular que permitan un adecuado conocimiento y seguimiento de EGB en el Perú.


ABSTRACT The aim of the study was to molecularly identify virulence and macrolide resistance genes in clinical isolates of Streptococcus agalactiae (GBS), recovered in 2019 from vaginal discharge (n=9) and urine (n=22), from two health facilities in Lima. Identification and antimicrobial susceptibility were determined by the Vitek® 2 automated system, identification was confirmed phenotypically; macrolide resistance was determined by the D-test method. Identification of virulence genes (lmb, bca and rib) and macrolide resistance genes (ermB, ermTR and mefA) was carried out by polymerase chain reaction (PCR). The predominant macrolide resistance phenotype and genotype were cMLSb (12/31) and ermB (11/31); the most frequent virulence gene was lmb (23/31). All were sensitive to penicillin, ampicillin and vancomycin. These findings show the need to implement molecular epidemiology studies that allow adequate knowledge and follow-up of GBS in Peru.

18.
Rev. peru. med. exp. salud publica ; 38(4): 577-586, oct.-dic. 2021. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1365926

ABSTRACT

RESUMEN Objetivo. Determinar la estructura genética de las cepas drogorresistentes de Mycobacterium tuberculosis que circularon en todo el Perú durante los años 2011-2015 a través de haplotipos obtenidos de un ensayo con sondas en línea. Materiales y métodos. Se analizaron 6589 muestras que ingresaron al Instituto Nacional de Salud para el diagnóstico rutinario mediante el ensayo GenoType® MTBDRplus v2, durante el periodo de estudio. Se crearon haplotipos resistentes mediante la concatenación de 21 sitios polimórficos de los genes evaluados por el ensayo con sondas en línea, y se realizó el análisis de asociación con fenotipos obtenidos por el método de proporciones agar 7H10. Resultados. Las mutaciones de mayores frecuencias fueron: rpoB S531L (55,4%) y rpoB D516V (18,5%) para la resistencia a rifampicina, y katG S315T (59,5%) e inhA c-15t (25,7%) para la resistencia a isoniacida. Se obtuvieron 13 haplotipos representativos (87,8% de muestras analizadas) de los cuales seis correspondieron al genotipo multidrogorresistente, cuatro al genotipo monorresistente a isoniacida y tres al genotipo monorresistente a rifampicina. Dieciocho departamentos, y la provincia del Callao, presentaron una alta diversidad haplotípica; cuatro presentaron moderada diversidad y dos presentaron baja diversidad. Conclusiones. Existe una alta diversidad haplotípica en la mayoría de los departamentos, además de una concentración de las cepas de Mycobacterium tuberculosis drogorresistentes en las ciudades de Lima y Callao. Asimismo, las cepas de Mycobacterium tuberculosis con perfil drogorresistente que circulan en el Perú contienen principalmente los marcadores genéticos de mayor prevalencia a nivel mundial asociados con la resistencia frente a rifampicina e isoniacida.


ABSTRACT Objective. To determine the genetic structure of drug-resistant strains of Mycobacterium tuberculosis that circulated throughout Peru during the years 2011-2015, by using haplotypes obtained from a line probe assay. Materials and methods. A total of 6589 samples that were admitted to the Instituto Nacional de Salud for routine diagnosis using the GenoType® MTBDRplus v2 assay were analyzed during the study period. Resistant haplotypes were created by concatenating 21 polymorphic sites of the evaluated genes using the line probe assay; and the association analysis was carried out with phenotypes obtained by the 7H10 agar ratio method. Results. The most frequent mutations were: rpoB S531L (55.4%) and rpoB D516V (18.5%) for rifampicin resistance, and katG S315T (59.5%) and inhA c-15t (25.7%) for isoniazid resistance. We obtained 13 representative haplotypes (87.8% of analyzed samples), 6 corresponded to the multidrug-resistant genotype, 4 to the isoniazid mono-resistant genotype and 3 to the rifampicin mono-resistant genotype. Eighteen regions and the province of Callao showed high haplotype diversity; four showed moderate diversity and two showed low diversity. Conclusions. Most regions showed high haplotype diversity; in addition, most drug-resistant strains of Mycobacterium tuberculosis were concentrated in the cities of Lima and Callao. Likewise, drug-resistant Mycobacterium tuberculosis strains circulating in Peru mainly contain the genetic markers with the highest prevalence worldwide, which are associated with resistance to rifampicin and isoniazid.

19.
Rev. Investig. Salud. Univ. Boyacá ; 8(2): 44-61, 20211201. tab
Article in Spanish | LILACS | ID: biblio-1369439

ABSTRACT

Introducción: Entre las infecciones asociadas con la atención en salud, las relacionadas con dispositivos constituyen la patología más común en los pacientes que ingresan al servicio de cuidados intensivos. Objetivos: Determinar la distribución de las infecciones asociadas con dispositivos, su perfil microbiológico y resistencia bacteriana en las unidades de cuidados intensivos del departamento de Casanare, Colombia entre 2019 y 2020. Materiales y métodos: Estudio observacional retrospectivo de corte transversal. La población de estudio fueron 93 pacientes admitidos entre enero de 2019 y diciembre de 2020 en dos unidades de cuidados intensivos del depar-tamento de Casanare. La información fue suministrada por la Secretaría de Salud Departamental, a través de los reportes de los laboratorios clínicos por medio del programa WHONET 5.6. Resultados: Las infecciones del torrente sanguíneo asociadas con el uso de catéter fueron las más frecuentes, con un 84 % (n: 78); seguidas de las infecciones sintomáticas de las vías urinarias asociadas con catéter, con un 12 % (n: 11), y en menor proporción las neumonías asociadas con ventilador mecánico, en un 4 % (n: 4). Las bacterias gramnegativas presentaron mayor frecuencia (61 %; n: 14) en relación con las grampositivas (39 %; n: 9). Conclusión: Las infecciones más frecuentes en los servicios analizados fueron las del torrente sanguíneo asociadas con el catéter y Pseudomonas aeruginosa fue el microrganismo más prevalente en los tres tipos de infección; mien-tras que el Enterococcus faecium fue resistente a una variedad de antibióticos. Tales resultados, al ser comparados con estudios realizados en varios países, demostraron que la distribución de estas infecciones es variable. Palabras clave: infecciones oportunistas; unidad de cuidados intensivos; dispositivos de acceso vascular; neumonía asociada al ventilador; infecciones relacionadas con catéteres; agentes antibacterianos; resistencia a medicamentos.


Introduction: Among health care associated infections, device associated infections are the most common pathology in patients admitted to the intensive care service. Objectives: To determine the distribution of device-associated infections, their microbiological profile and bacterial resistance, in the intensive care units of the Department of Casanare between 2019 and 2020. Materials and methods: An observational, retrospective, cross-sectional study was carried out. The study population was 93 patients admitted between January 2019 and December 2020 in two Inten-sive Care Units of the Department of Casanare. The information was provided by the Departmental Health Secretariat through the reports of the Clinical Laboratories through the WHONET 5.6 program. Results: Catheter-associated bloodstream infections were the most frequent with 84% (n: 78), fo-llowed by catheter-associated symptomatic urinary tract infections with 12% (n: 11) and associated pneumonia to a lesser extent 4% mechanical ventilator (n: 4). Gram negative bacteria had a higher frequency 61% (n: 14) compared to Gram positive ones 39% (n: 9). Conclusion: The infection associated with devices, the most frequent in the analyzed services were the infections of the blood stream associated with the catheter and P. aeruginosa was the most preva-lent microorganism in the three types of infection. E. faecium presented resistance to a variety of an-tibiotics, results that when compared with studies carried out in several countries worldwide showed that the distribution of these infections is variable.


Introdução: Entre as infecções associadas aos cuidados de saúde, as infecções associadas a dispositi-vos são a patologia mais comum em pacientes internados em terapia intensiva. Objetivo: Determinar a distribuição de infecções associadas a dispositivos, seu perfil microbiológico e resistência bacteriana em unidades de terapia intensiva no departamento de Casanare, Colômbia entre 2019 e 2020. Materiais e métodos: Estudo retrospectivo observacional transversal. A população do estudo foi de 93 pacientes admitidos entre janeiro de 2019 e dezembro de 2020 em duas unidades de terapia in-tensiva no departamento de Casanare. As informações foram fornecidas pela Secretaria de Saúde do Departamento, através de informes de laboratório clínico utilizando o programa WHONET 5.6. Resultado: As infecções da corrente sanguínea associadas a cateteres foram as mais frequentes com 84% (n: 78), seguidas pelas infecções do trato urinário sintomáticas associadas a cateteres com 12% (n: 11), e em menor grau as pneumonias associadas a ventiladores mecânicos com 4% (n: 4). As bac-térias gram-negativas eram mais frequentes (61%; n: 14) do que as gram-positivas (39%; n: 9). Conclusão: As infecções mais frequentes nos serviços analisados foram infecções associadas a cate-teres e Pseudomonas aeruginosa foi o microrganismo mais prevalente nos três tipos de infecção, en-quanto Enterococcus faecium era resistente a uma variedade de antibióticos. Tais resultados, quando comparados com estudos realizados em vários países, demonstraram que a distribuição dessas infe-cções é variável.


Subject(s)
Opportunistic Infections , Drug Resistance , Pneumonia, Ventilator-Associated , Catheter-Related Infections , Vascular Access Devices , Intensive Care Units , Anti-Bacterial Agents
20.
Article in English | LILACS-Express | LILACS | ID: biblio-1354946

ABSTRACT

Background: Antibiotic resistance is considered to be the next worldwide epidemic. Urinary tract infections (UTI) are the second most common cause of infection, which also has the highest resistance frequency. Nevertheless, in high Andean regions, little is known about the antibiotic resistance. Objectives: Determine the antimicrobial resistance patterns of the enterobacteriaceae family isolated from urinary tract infections of a Peruvian Andean region. Material and Methods: Aretrospective cross-sectional review of 1717 records from the microbiology service of a private health institution from Puno - Peru, was done between the years 2014 and 2017. Antibiotic resistance by uropathogens was studied among different age groups. Statistical analysis included Chi2 test with a p<0.05. Poisson regression was used to calculate the prevalence ratio (PR) with a 95% confidence interval. Results: There was a wide distribution of antibiotic resistance among all the antibiotics, mainly in Escherichia coli and Proteus spp. The elderly had the highest prevalence of antibiotic resistance. As age increased, resistance to all drugs also increased (p<0.01). Furthermore, the elderly had a risk probabilityofresistanceof1.22,1.42,1.20and1.32topenicillins, cephalosporins, quinolones and other antibiotics respectively. Conclusion: The antimicrobial resistance patterns of the Peruvian Andean region were lower than national and international patterns.


Introducción: La resistencia a antibióticos es considerada la próxima epidemia mundial. Las infecciones del tracto urinario (ITU) son la segunda causa más común de infecciones y la que presenta mayor frecuencia de resistencia. Sin embargo, poco se ha reportado en regiones altos-andinas. Objetivo: Evaluar los patrones de resistencia antimicrobiana de la familia enterobacteriaceae aisladas de infecciones del tracto urinario de pacientes ambulatorios de una región altoandina peruana y sus factores asociados. Material y Métodos: Estudio transversal analítico retrospectivo, a partir de 1717 registros del Servicio de Microbiología de una institución de salud en la región Puno ­ Perú, entre los años 2014 al 2017. Se estudió la resistencia a antibióticos según uropatógeno en diferentes grupos etarios. Se empleó la prueba de Chi2 de Pearson y un modelo de regresión de Poisson para calcular la razón de prevalencias (RP). En todos los análisis se consideró un valor de p<0.05 como significativo y se estimaron intervalos de confianza al 95%. Resultados: Se presentó una amplia distribución de resistencia en todos los fármacos evaluados, siendo mayor en Escherichia coli y Proteus spp. El grupo etario, ≥ 60 años, presentó la mayor prevalencia de resistencia bacteriana. A medida que la edad aumentaba, la resistencia a todos los fármacos estudiados también aumentó (p <0.01). Así mismo, los pacientes ≥ 60 años presentaron mayor probabilidad de presentar resistencia bacteriana a penicilinas, cefalosporinas y quinolonas. Conclusión: El patrón de resistencia a los antibióticos utilizados en ITUs en la zona altoandina peruana incrementa con la edad.

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