ABSTRACT
In the present article, the pathophysiology, evaluation and management guidelines of diabetic foot infections are reviewed with a view to reducing the medical morbidity, psychological distress and financial costs.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Bacteria, Aerobic/pathogenicity , Debridement , Diabetic Foot/microbiology , Gram-Positive Cocci/pathogenicity , Humans , Patient Care Planning , Self Care , Wound Healing , Wound Infection/drug therapyABSTRACT
Background: During the last decade, there has been a progressive increase in the resistance of gram (+) cocci to betalactamics and other antimicrobials. Therefore, vancomycin and teicoplanin have incorporated as alternative antimicrobial drugs. Aim: To assess the susceptibility of gram (+) cocci to different antimicrobials including vancomycin and teicoplanin. Material and methods: We studied 447 strains of gram (+) cocci coming from ambulatory and hospitalized patients. These included 308 enterococcus sp strains, 99 staphycoccus aureus strains and 40 coagulase negative staphylococci strains. Enterococci susceptibility was measured using minimal inhibitory concentrations in agar and that of staphylococci, through diffusion. Susceptibility to vancomycin and teicoplanin was measured using minimal inhibitory concentrations in all strains. Results: Enterococcus faecalis was 100 percent susceptible to ampicillin, penicillin, vancomycin and teicoplanin, 23 percent susceptible to tetracyclin and 47 percent to chloramphenicol. Susceptibility of E faecium was 61 percent to penicillin, 49 percent to chloramphenicol, 41 percent to tetracyclin, 100 percent to vancomycin and teicoplanin. Of 19 enterococcus spp strains, 90 percent were susceptible to ampicillin, 80 percent to penicillin, 55 percent to chloramphenicol and 45 percent to tetracyclin. Only one E casseiflavus strain had a low level resistance to vancomycin and was susceptible to teicoplanin. No staphylococcus aureus strain was resistant to vancomycin or teicoplanin. Conclusions: A permanent surveillance of gram (+) cocci antimicrobial susceptibility is required to update therapeutic schemes
Subject(s)
Humans , Drug Resistance, Microbial , Gram-Positive Bacterial Infections/drug therapy , Gram-Positive Cocci/drug effects , Staphylococcus aureus/drug effects , Staphylococcus aureus/pathogenicity , Microbial Sensitivity Tests , Enterococcus/drug effects , Enterococcus/pathogenicity , Gram-Positive Cocci/pathogenicity , Lactams/pharmacology , Methicillin/pharmacology , Anti-Bacterial Agents/pharmacology , beta-Lactam ResistanceABSTRACT
Se presenta un caso de infección por leuconostoc spp en la mano, probablemente como secuela de infiltración por dedo en gatillo, estudiado y tratado por un equipo de profesionales de varias especialidades: cirujanos, internistas, infectólogos, patólogos, laboratorio y rehabilitación. El motivo de consulta fue por incapacidad funcional de la mano, con todos los Signos de Celso en el dedo anular derecho, sin mejoría con el tratamiento previo a realizarse el diagnóstico, que fué hecho por el cultivo del espécimen quirúrgico de la sinovitis extirpada quirúrgicamente, reafirmado que se trataba de Leuconostoc spp en el CDC de Atlanta USA. El paciente se reintegró a todas sus actividades después de la cirugía, tratamiento con Clindamicina IV, por 3 semanas y 12 semanas de rehabilitación