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1.
Rev. Odontol. Araçatuba (Impr.) ; 42(3): 45-49, set.-dez. 2021. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1291672

ABSTRACT

Os ferimentos por arma de fogo (FAF) são um grande problema de saúde pública. Na face, a mandíbula é o local de maior incidência, sendo a região de corpo mandibular a mais atingida e as lesões aos tecidos moles frequentemente a ela associadas. Em alguns casos, tais ferimentos apresentam-se de difícil resolução, sobretudo, em casos de fraturas cominutivas e lesões de tecidos moles com alta complexidade. Isso torna o atendimento desses pacientes um desafio para cirurgiões buco-maxilo-faciais. Desta forma, o objetivo deste artigo é relatar um caso de FAF em terço inferior da face, com comprometimento de tecidos moles e mandíbula, pela equipe de Cirurgia e Traumatologia Bucomaxilofacial do Hospital Geral do Estado - Bahia. Paciente de 28 anos de idade, sexo feminino, vítima de FAF em terço inferior da face, por disparo acidental de espingarda. Ao exame clínico, pode-se observar ferimento perfuro-contuso em região de mandíbula e fratura cominutiva de corpo e ângulo mandibular à direita. A paciente foi submetida à cirurgia para remoção de fragmentos ósseos/corpos estranhos, fixação dos cotos com placa de reconstrução 2.4mm e sutura dos planos, em mesmo tempo cirúrgico, reestabelecendo a função da mandíbula. Portanto, devido à fisiopatologia variável dos FAF na mandíbula, não se indica um único padrão de tratamento para as fraturas cominutivas. Além disso, é indispensável o emprego de protocolos de limpeza cirúrgica imediata e antibioticoterapia nos casos com alto grau de cominuição, bem como, sugere-se realizar o tratamento definitivo o mais breve possível(AU)


Firearm injuries (FIs) are a major public health problem. On the face, the mandible is the place with the highest incidence of this trauma, with the mandibular body region being the most affected and the lesions to the soft tissues frequently associated with it. In some cases, such injuries are difficult to resolve, especially in cases of comminuted fractures and soft tissue injuries with high complexity. This makes the care of these patients a challenge for oral and maxillofacial surgeons. Thus, the objective of this article is to report a case of care for a FAF victim in the lower third of the face, with soft tissue and mandible involvement, by the Maxillofacial Surgery and Traumatology team at the Hospital Geral do Estado - Bahia. 28-year-old female patient, victim of FAF in the lower third of the face, due to acidental shotgun firing. On clinical examination, a perforated-blunt wound can be seen in the mandible region and comminuted fracture of the body and angle of the mandible on the right. The patient underwent surgery to remove bone fragments / foreign bodies, fix the stumps with a 2.4 mm reconstruction plate and suture the planes, at the same surgical time, reestablishing the function of the mandible. Therefore, due to the variable pathophysiology of FAF in the mandible, a single treatment pattern is not indicated for comminuted fractures. In addition, it is essential to use immediate surgical cleaning protocols and antibiotic therapy in cases with a high degree of comminution, as well as, it is suggested to carry out the definitive treatment as soon as possible(AU)


Subject(s)
Humans , Female , Adult , Wounds, Gunshot , Soft Tissue Injuries , Fractures, Comminuted , Oral and Maxillofacial Surgeons , Fractures, Bone , Jaw Fractures , Mandible , Anti-Bacterial Agents
2.
Infectio ; 25(4): 212-240, oct.-dic. 2021. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1286716

ABSTRACT

Abstract Intra-abdominal infections are frequent at all levels of health care, therefore, it is necessary to maintain a high level of clinical suspicion, performing the fastest and most cost-effective measures to confirm the diagnosis and offer a precise and targeted multidisciplinary therapy, this being the only way to have an impact on the morbidity of this infection, reducing mortality and minimizing the complications and costs of health care. Intra-abdominal infections are linked to the appearance and selection of resistant mutants in both bacteria and fungi, becoming currently a major public health problem. Increasing bacterial resistance when associated with a greater possibility of difficulties in antimicrobial treatment increases mortality. This evidence-based consensus brings together the recommendations for the diagnosis and treatment of intra-abdominal infections in the pediatric and adult population. With strict monitoring of bacterial resistance and stimulating the control of the risk factors that have the greatest impact on the appearance of this phenomenon, this consensus is intended to be a practical guide that is easy to implement, and with periodic updates it will favor and facilitate multidisciplinary and the adequacy of the therapeutic management of intra-abdominal infections.


Resumen Las infecciones intrabdominales son frecuentes en todos los niveles de atención en salud, por ende, es necesario mantener un alto nivel de sospecha clínica, realizando las medidas más rápidas y costoefectivas para confirmar el diagnóstico y así ofrecer de una forma precisa y dirigida la terapéutica multidisciplinaria, siendo esta la única manera de tener impacto en la morbilidad de esta infección, disminuyendo la mortalidad y minimizando las complicaciones y los costos de la atención en salud. Las infecciones intrabdominales se encuentran ligadas a la aparición y selección de las mutantes resistentes tanto en las bacterias como en los hongos, convirtiéndose en la actualidad en una gran problemática en la salud pública. La creciente resistencia bacteriana al asociarse a mayor posibilidad de dificultades en el tratamiento antimicrobiano incrementa la mortalidad. Este consenso basado en la evidencia, reúne las recomendaciones en el diagnóstico y en el tratamiento de las infecciones intrabdominales en la población pediátrica y de adultos. Con un estricto seguimiento de la resistencia bacteriana y estimulando el control de los factores de riesgo que tienen mas impacto en la aparición de este fenómeno, este consenso pretende ser una practica guía de fácil implementación, y con periódicas actualizaciones favorecerá y facilitará el manejo multidisciplinario y la adecuación del manejo terapéutico de las infecciones intrabdominales.


Subject(s)
Humans , Child , Adult , Intraabdominal Infections , Peritonitis , Bacteria , Risk Factors , Mortality , Colombia , Sepsis , Delivery of Health Care , Infections , Anti-Bacterial Agents
3.
Braz. j. oral sci ; 20: e213690, jan.-dez. 2021. ilus
Article in English | LILACS, BBO | ID: biblio-1281104

ABSTRACT

Aim: to develop a model for regenerative endodontics using newly-weaned Wistar rats immature molars with pulp necrosis to histologically describe the evolution of apical tissues following treatment with a bi-antibiotic paste, induced bloodclot formation and MTA. Methods: Ten 25-day-old female Wistar rats were divided into an initial control group (Ci) and two experimental groups in which pulp necrosis was experimentally induced on the left mandibular first molar by exposing the pulp chamber and leaving it open to the oral environment. One of the experimental groups was left untreated (E1) while the other was submitted to a protocol of regenerative endodontics 10 days thereafter (E2). Fifteen days after placement of a bi-antibiotic paste, bleeding was induced into the root canal space and MTA was placed upon. Animals were euthanized 30 days later. Right mandibular first molars served as an 80-day-old final control group (Cf). Each hemimandible was histologically processed to analyse parameters associated with root development. Statistical analysis was carried by means of ANOVA; p values below 0.05 were considered statistically significant. Results: baseline (i.e. 25-days old) mean root length and apical diameter of the distal root canal were 1.84±0.25 and 0.38±0.02mm respectively. Following the regenerative endodontic protocol, cells lining the walls of the root canal and significant increase to both length (2.37±0.22mm) and diameter (0.32±0.03 mm) were observed. Conclusions: newly-weaned Wistar rats serve as a suitable model to evaluate regenerative endodontic protocols. However, further research is needed in order to disclose the nature of the cells and/or cell mediators involved


Subject(s)
Animals , Rats , Root Canal Therapy , Dental Pulp Necrosis , Regenerative Endodontics , Anti-Bacterial Agents
4.
Arch. pediatr. Urug ; 92(2): e212, dic. 2021. tab
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1339132

ABSTRACT

Introducción: la sepsis tardía por estafilococo coagulasa negativo (SCoN) es una causa común de morbimortalidad en la unidad neonatal. Los SCoN son los microorganismos más frecuentemente involucrados con aproximadamente el 50% de los casos. El objetivo de este estudio es analizar la incidencia y las características de los neonatos portadores de sepsis tardía por SCoN. Materiales y métodos: se realizó un estudio descriptivo, longitudinal, retrospectivo. Se utilizaron las bases de datos del laboratorio de microbiología del hospital y las historias clínicas electrónicas para obtener la información. El período de estudio analizado fueron los años 2018 y 2019 en la unidad de cuidados intensivos e intermedios de recién nacidos del Centro Hospitalario Pereira Rossell. Resultados: obtuvimos una incidencia de 2,5% de los ingresos a cuidados intensivos e intermedios (25 pacientes). La edad gestacional al nacer fue de 28 semanas (25,0-35,0) y la mediana del peso fue de 1.070 g (730,0-2.365,0). La media de edad gestacional posmenstrual al momento del diagnóstico fue de 32,92±7,921 semanas. Por sospecha de sepsis precoz, 17 pacientes habían recibido un curso de antibióticos previo. El signo clínico más frecuentemente observado fue el deterioro del estado general, en 11 pacientes, seguido de distensión abdominal en 6 y fiebre en 5. Dentro de los SCoN, el más frecuentemente aislado fue el Staphylococcus epidermidis (13 pacientes); 22 pacientes recibieron tratamiento, 18 de ellos con vancomicina-meropenem y 4 con monoterapia con vancomicina. Conclusión: estos patógenos representan una causa importante de morbimortalidad en la unidad neonatal, particularmente en pacientes que presentan mayor gravedad y mayor necesidad de soporte vital. Se necesitan pautas claras de interpretación del rol de estos microorganismos y de abordaje de pacientes con riesgo de sepsis tardía, incluyendo el tratamiento antibiótico empírico.


Introduction: Coagulase Negative Staphylococci (CoNS) late onset sepsis is a common cause of morbidity and mortality in the neonatal intensive care unit (NICU). CoNS are the most frequently isolated microorganisms and total 50% of cases. The objective of this study is to analyze the incidence and characteristics of newborns carriers of late onset CoNS. Materials and methods: we performed a descriptive, retrospective, longitudinal study. Data was obtained from the hospital's microbiology laboratory database and electronic medical records. Patients included were those admitted to NICU during the period between 2018 and 2019. Results: we obtained an incidence of 2.5% of patients admitted to the NICU (25 patients). Median gestational age at birth was 28 weeks 25.0-35.0 and median birth weight was 1.070 g 730.0-2365.0. Mean gestational age at the time of diagnosis was 32.92±7.921 weeks. 17 patients had received an antibiotics course at birth because of early onset sepsis suspicion. The most frequently observed clinical symptom was deterioration of general condition, 11 patients, followed by abdominal distention in 6 and fever in 5. Among CoNS, the most frequently isolated pathogen was Staphylococcus epidermidis (13 patients). 22 patients received treatment, 18 a combination of vancomycin and meropenem and 4 received vancomycin monotherapy. Conclusion: these pathogens are a common cause of morbidity and mortality in the newborn intensive care unit, particularly in patients with more serious conditions and in those who require more advanced life support measures. Clearer interpretation of their role is needed as well as to determine a proper approach to patients at risk of late onset sepsis, including empiric antibiotic treatment.


Sepse tardia para Staphylococcus coagulase negativa (SCoN) é uma causa comum de morbidade e mortalidade na unidade neonatal. SCoNs são os microrganismos mais frequentemente envolvidos e representam aproximadamente 50% dos casos. O objetivo deste estudo é analisar a incidência e as características de neonatos com sepse tardia por SCoN. Materiais e métodos: foi realizado um estudo descritivo, longitudinal e retrospectivo. Usamos os bancos de dados do laboratório de microbiologia e prontuários médicos eletrônicos de nosso hospital para obter as informações. O período de estudo analisado foi de 2018 e 2019 na unidade de terapia intensiva e intermediária para recém-nascidos do Centro Hospitalar Pereira Rossell. Resultados: obtivemos uma incidência de 2,5% de internações em Terapia Intensiva e Intermediária (25 pacientes). A idade gestacional ao nascer foi de 28 semanas 25,0-35,0 e o peso médio foi de 1070g 730,0-2365,0. A média da idade gestacional pós-menstrual no momento do diagnóstico foi de 32,92 ± 7,921 semanas. 17 pacientes haviam recebido um curso anterior de antibióticos por suspeita de sepse precoce. O sinal clínico mais frequentemente observado foi deterioração do estado geral em 11 pacientes, seguido por distensão abdominal em 6 e febre em 5. Dentre os SCoN, o mais isolado foi o Staphylococcus Epidermidis (13 pacientes). 22 pacientes receberam tratamento, 18 deles com Vancomicina-Meropenem e 4 com Vancomicina em monoterapia. Conclusão: esses patógenos representam uma importante causa de morbimortalidade na unidade neonatal, principalmente em pacientes com maior gravidade e maior necessidade de suporte de vida. Orientações claras são necessárias para interpretar o papel desses microrganismos e para abordar pacientes com risco de sepse tardia, incluindo tratamento com antibióticos.


Subject(s)
Humans , Female , Infant, Newborn , Staphylococcal Infections/epidemiology , Neonatal Sepsis/epidemiology , Staphylococcal Infections/diagnosis , Staphylococcal Infections/drug therapy , Staphylococcus epidermidis/virology , Uruguay/epidemiology , Vancomycin/therapeutic use , Cross Infection , Epidemiology, Descriptive , Incidence , Retrospective Studies , Longitudinal Studies , Coagulase , Staphylococcus haemolyticus/virology , Staphylococcus hominis/virology , Anti-Bacterial Agents/therapeutic use
5.
Arch. pediatr. Urug ; 92(2): e306, dic. 2021. ilus, tab
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1278306

ABSTRACT

Los estafilococos coagulasa negativos son microorganismos frecuentemente aislados cuya significancia clínica puede ser difícil de establecer por su carácter de comensales habituales de la piel. En la población neonatal estos patógenos han ido adquiriendo mayor protagonismo debido a la sobrevida de pacientes mas prematuros que en el pasado, así como sus necesidades de tratamiento, que determinan mayores tiempos de estadía hospitalaria. Estos elementos representan factores de riesgo también para el desarrollo de endocarditis en estos pacientes, particularmente debido a la utilización de catéteres intravasculares centrales por tiempo prolongado. En este caso clínico se presenta un paciente pretérmino severo que presentó una endocarditis a estafilococo coagulasa negativo a partir del cual discutiremos las características de las infecciones por estos microorganismos, las características de la endocarditis infecciosa en el recién nacido pretérmino y la utilización de antibióticos en estos pacientes, así como algunos elementos asociados a la vigilancia activa en el uso de antibióticos.


Coagulase negative staphylococcus (CoNS) are commonly isolated microorganisms whose clinical importance may be difficult to establish due to their role as part of our usual skin microbiota. These pathogens have gained relevance in neonatal population due to an improvement in neonatal care that determine longer survival rates and hospitals stays. Neonatal endocarditis is also affected by these microorganisms and particularly by the use of central intra vascular lines for long periods of time. In this clinical case we introduce a severe preterm patient who developed a CoNS endocarditis and discuss the characteristics of CoNS infections and endocarditis in preterm newborns as well as some antibiotic vigilance principles.


Os estafilococos coagulase negativos são microrganismos frequentemente isolados, cujo significado clínico pode ser difícil de estabelecer devido ao seu caráter de comensais cutâneos comuns. Na população neonatal, esses patógenos vêm adquirindo maior destaque devido à sobrevida de pacientes mais prematuros do que no passado, bem como suas necessidades de tratamento, as quais determinam tempos de internação mais longos. Esses elementos também representam fatores de risco para o desenvolvimento de endocardite nesses pacientes, principalmente pelo uso prolongado de cateter intravascular central. Neste caso clínico apresentaremos um paciente pré-termo grave que apresentou endocardite estafilocócica coagulase-negativa a partir do qual discutiremos as características das infecções por esses microrganismos, as características da endocardite infecciosa no recém-nascido pré-termo e o uso de antibióticos nesses pacientes bem como alguns elementos associados à vigilância ativa no uso de antibióticos.


Subject(s)
Humans , Female , Staphylococcal Infections/diagnosis , Staphylococcal Infections/drug therapy , Staphylococcus epidermidis/virology , Vancomycin/therapeutic use , Endocarditis/diagnosis , Anti-Bacterial Agents/therapeutic use , Staphylococcal Infections/complications , Coagulase , Infant, Very Low Birth Weight , Endocarditis/etiology , Infant, Extremely Premature
6.
Arq. Ciênc. Vet. Zool. UNIPAR (Online) ; 24(2, cont.): e2407, jul-dez. 2021. tab, graf
Article in English | ID: biblio-1352314

ABSTRACT

The factors that arouse interest in the study of essential oils as biocidal agents are numerous, such as the fact that they have antibacterial, antifungal, insecticidal, antioxidant, anti-inflammatory and larvicidal properties. The objective of this work was to evaluate the antimicrobial activity, in vitro, of the laurel (Laurus nobilis L) essential oil on the growth of pathogenic bacteria Salmonella enterica serovar Typhimurium ATCC 14028 and Staphylococcus aureus ATCC 25923, at different exposure times, as well as to perform the chemical characterization. Twenty compounds were identified and quantified, representing 96.57% of the total composition. The class of oxygenated monoterpenes represented the majority class of the essential oil, with 1,8-cineol (33.8%) as the substance found in greater quantity, followed by linalool (17.79%). The third constituent in greater quantity was sabinene (12.23%), belonging to the group of monoterpene hydrocarbons. Terpinyl acetate (9.41%) was also considered to be quantitatively representative. Laurel essential oil showed bacteriostatic activity against S. Typhimurium ATCC 14028 and S. aureus ATCC 25923.(AU)


Os fatores que despertam interesse no estudo dos óleos essenciais como agentes biocidas são inúmeros, como o fato de possuírem propriedades antibacteriana, antifúngica, inseticida, antioxidante, antiinflamatória e larvicida. O objetivo deste trabalho foi avaliar a atividade antimicrobiana, in vitro, do óleo essencial de louro (Laurus nobilis L) sobre o crescimento das bactérias patogênicas Salmonella enterica sorovar Typhimurium ATCC 14028 e Staphylococcus aureus ATCC 25923, em diferentes tempos de exposição, assim como realizar a caracterização química do óleo. Vinte compostos foram identificados e quantificados, representando 96,57% da composição total. A classe dos monoterpenos oxigenados representou a classe majoritária do óleo essencial, sendo o 1,8-cineol (33,8%) a substância encontrada em maior quantidade, seguido do linalol (17,79%). O terceiro constituinte em maior quantidade foi o sabineno (12,23%), pertencente ao grupo dos hidrocarbonetos monoterpênicos. O acetato de terpinila (9,41%) também foi considerado quantitativamente representativo. O óleo essencial de louro apresentou atividade bacteriostática contra S. Typhimurium ATCC 14028 e S. aureus ATCC 25923.(AU)


Los factores que despiertan interés en el estudio de los aceites esenciales como agentes biocidas son innumerables, como el hecho de que tienen propiedades antibacterianas, anti fúngicas, insecticidas, antioxidantes, antiinflamatorias y larvicidas. El objetivo de este trabajo ha sido evaluar la actividad antimicrobiana, in vitro, del aceite esencial de laurel (Laurus nobilis L) sobre el crecimiento de bacterias patógenas Salmonella enterica serovar Typhimurium ATCC 14028 y Staphylococcus aureus ATCC 25923, en diferentes momentos de exposición, así como realizar la caracterización química del aceite. Se identificaron y cuantificaron veinte compuestos, que representan el 96,57% de la composición total. La clase de mono terpenos oxigenados representó la clase principal de aceite esencial, siendo el 1,8-cineol (33,8%) la sustancia que se encuentra en mayor cantidad, seguida del linalol (17,79%). El tercer constituyente en mayor cantidad fue el sabineno (12,23%), perteneciente al grupo de los hidrocarburos monoterpénicos. El acetato de terpinilo (9,41%) también se consideró cuantitativamente representativo. El aceite esencial de laurel mostró actividad bacteriostática contra S. Typhimurium ATCC 14028 y S. aureus ATCC 25923.(AU)


Subject(s)
Staphylococcus aureus , Salmonella enterica , Laurus/chemistry , Antioxidants , In Vitro Techniques , Anti-Bacterial Agents
7.
Arq. Ciênc. Vet. Zool. UNIPAR (Online) ; 24(2, cont.): e2405, jul-dez. 2021. ilus
Article in Portuguese | ID: biblio-1352310

ABSTRACT

A castração em fêmeas pode ser feita pela ovariectomia (retirada dos ovários), ou ovariohisterectomia (retirada dos ovários e do útero). Essa última técnica é a mais recomendada em cães e gatos, devido à prevenção de afecções que podem ocorrer posteriormente no útero. Dentre essas complicações pode-se encontrar sangramento por ligadura mal feita em coto, hidroureter, hidronefrose, piometra de coto, formação de tratos sinusais, aderência, obstrução crônica, incontinência urinária, retenção abdominal de compressas cirúrgicas, transcecção de parte do ureter e ovário remanescente. Em cadelas castradas, a causa mais comum da formação de tratos sinusais é a presença de reação tecidual ao redor do fio de sutura. O presente estudo teve como objetivo relatar um caso de uma cadela sem raça definida, 8,7 kg, seis anos, que deu entrada no Hospital Veterinário de Uberaba, MG com queixa principal a presença de ferida no flanco direito sendo tratada há nove meses, porém sem sucesso. Já haviam feito uso de vários antibióticos sistêmicos e antinflamatorios esteroidais e não esteroidais. Diante do caso observado, foram realizados exames laboratoriais e de imagem. Perante o resultado do exame de imagem, a principal suspeita foi a formação de trato sinusal com comunicação com a cavidade abdominal devido a uma reação ao fio de algodão utilizado na ovariohisterectomia.(AU)


Female animals can be castrated by ovariectomy (removal of the ovaries), or ovariohysterectomy (removal of the ovaries and uterus). The latter is the most recommended in dogs and cats due to the prevention of conditions that may subsequently occur in the uterus. Among these complications, one can find bleeding by poor ligation in the stump, hydroureter, hydronephrosis, stump pyometra, formation of sinus tracts, adherence, chronic obstruction, urinary incontinence, abdominal retention of surgical compresses, transection of part of the ureter and remaining ovary. In castrated bitches, the most common cause of the formation of sinus tracts is the presence of tissue reaction around the suture thread. This study aimed at reporting a case of a mixed breed, six-year-old dog, 8.7 kg that was admitted to the Veterinary Hospital of Uberaba with the main complaint of the presence of a wound on the right flank being unsuccessfully treated for nine months. Several systemic antibiotics and steroidal and non-steroidal anti-inflammatory drugs had already been used. In view of the observed case, laboratory and imaging exams were performed. In view of the result of the imaging examination, the main suspicion was the formation of a sinus tract with communication to the abdominal cavity due to a reaction to the cotton thread used in the ovariohysterectomy.(AU)


La castración en hembras se puede realizar mediante ovariectomía (extirpación de los ovarios) u ovario histerectomía (extirpación de los ovarios y del útero). Esa última técnica es la más recomendada en perros y gatos, debido a la prevención de afecciones que pueden presentarse posteriormente en el útero. Entre estas complicaciones se puede encontrar hemorragias por ligadura mal realizada en muñón, hidruréter, hidronefrosis, piometra de muñón, formación de tractos sinusales, adherencia, obstrucción crónica, incontinencia urinaria, retención abdominal de compresas quirúrgicas, transección de parte del uréter y ovario remanente. En las perras castradas, la causa más común de formación de trayectos sinusales es la presencia de reacción tisular alrededor del hilo de sutura. El presente estudio tuvo como objetivo reportar el caso de una perra sin raza definida, de 8,7 kg, de seis años de edad, que ingresó en el Hospital Veterinario de Uberaba, MG con el principal síntoma de presencia de una herida en el flanco derecho siendo tratada durante nueve meses, pero sin éxito. Ya habían usado varios antibióticos sistémicos y medicamentos antiinflamatorios esteroides y no esteroides. A la vista del caso observado, se realizaron exámenes de laboratorio y de imagen. A la vista del resultado del examen de imagen, la principal sospecha fue la formación de un tracto sinusal con comunicación con la cavidad abdominal debido a una reacción al hilo de algodón utilizado en el ovario histerectomía.(AU)


Subject(s)
Animals , Female , Dogs , Ovary , Sutures , Ovariectomy , Castration , Dogs/surgery , Pyometra , Anti-Bacterial Agents
8.
Medicina UPB ; 40(2): 33-40, 13 oct. 2021. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1342178

ABSTRACT

Objetivo: caracterizar desde el punto de vista microbiológico las infecciones periprotesicas (IP) de los pacientes sometidos a remplazo articular de rodilla o cadera, en la IPS universitaria Clínica León XIII, y evidenciar los patrones más comunes de resistencia a los antibióticos, en el periodo 2015-2018. Metodología: se recolectó información de 25 pacientes llevados a remplazo articular de rodilla o cadera en la IPS universitaria, sede Clínica León XIII, durante el periodo de 2015-2018, que desarrollaron IP. Se obtuvo información sobre características demográfica, clínicas y patrones de resistencia (según antibiograma), y sobre los criterios usados para diagnosticarla. Los datos se registraron, según la naturaleza y distribución de la variable, en medias o medianas para las variables cuantitativas, y en frecuencias para las cualitativas. Resultados: entre 2015 y 2018 se realizaron 541 remplazos articulares, la incidencia de infección periprotésica fue de 4.6% (25 pacientes), 22 casos (88%) con crecimiento microbiológico. El germen más frecuente fue el S. aureus, con patrón alto de resistencia para meticilina (SAMR), en el 44%. Seguido por K. pneumoniae, con un patrón de resistencia por producción de betalactamasas de espectro extendido (BLEE) de 83%. Ninguno tuvo resistencia a los carbapenémicos. Conclusiones: los resultados son similares a los reportados en la literatura internacional. Sigue siendo el S. aureus el principal causante de la infección periprotésica, seguido de los gérmenes gram negativos.


Objective: to microbiologically characterize the periprosthetic infections (PI) of patients undergoing knee or hip joint replacement at IPS Universitaria Clínica León XXIIIin the period 2015-2018, and to demonstrate the most common antibiotic resistance patterns. Methodology: the information was collected from 25 patients undergoing knee or hip joint replacement at IPS Universitaria Clínica León XXIII during the period 2015-2018 who developed PI. Data was obtained on demographic, clinical characteristics, and antibiotic resistance patterns (according to antibiograms), as well as on the diagnostic criteria used to diagnose it. The data was recorded, according to the nature and distribution of the variable, in means or medians for the quantitative variables, and in frequencies for the qualitative variables.Results:between 2015-2018, 541 joint replacements were performed. There was an incidence of periprosthetic infection in 25 patients (4.6%), 22 of whom (88%) had micro-biological growth. The most frequent germ was S. aureus, which had a high resistance pattern for methicillin-resistant S. aureus (MRSA) in 44%, followed by K. pneumoniaewith a positive extended spectrum beta-lactamase (ESBL) in 83%. None of them showed resistance to carbapenems.Conclusions: the results found are similar to those reported in the international lite-rature. This investigation evidenced that S. aureus continues to be the main cause of periprosthetic infection, followed by gram-negative germs.


Objetivo: caracterizar do ponto de vista microbiológico as infecções periprotéticas (IP) dos pacientes submetidos à artroplastia articular do joelho ou do quadril, na IPS universitário, Clínica León XIII, e demonstrar os padrões mais comuns de resistência aos antibióticos, em o período 2015-2018.Metodologia: foram coletadas informações de 25 pacientes encaminhados para prótese de joelho ou quadril no IPS universitário, sede da Clínica León XIII, no período 2015-2018, que desenvolveram IP. Foram obtidas informações sobre as características demográfi-cas, clínicas e padrões de resistência (de acordo com antibiograma) e sobre os critérios usados para diagnosticá-la. Os dados foram registrados, de acordo com a natureza e distribuição da variável, em médias ou medianas para as variáveis quantitativas e em frequências para as qualitativas.Resultados: entre 2015 e 2018, foram realizadas 541 substituições articulares, a incidência de infecção periprotética foi de 4,6% (25 pacientes), 22 casos (88%) com crescimento microbiológico. O germe mais frequente foi S. aureus, com alto padrão de resistência à meticilina (MRSA), em 44%. Seguido por K. pneumoniae, com padrão de resistência devido à produção de beta-lactamase de espectro estendido (ESBL) de 83%. Nenhum apresentou resistência aos carbapenêmicos.Conclusões: os resultados são semelhantes aos relatados na literatura internacional. S. aureus continua a ser a principal causa de infecção periprotética, seguido por germes gram-negativos.


Subject(s)
Humans , Prostheses and Implants , Drug Resistance, Microbial , Methicillin-Resistant Staphylococcus aureus , Hip Joint , Infections , Joints , Knee , Anti-Bacterial Agents
9.
Rev. cuba. hematol. inmunol. hemoter ; 37(3): e1418, 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1341393

ABSTRACT

Introducción: El pronóstico de las enfermedades hematológicas malignas ha experimentado un importante avance en las últimas décadas, sobre todo por las nuevas combinaciones de quimioterapia. Estos hechos han propiciado que muchos de estos pacientes, en algún momento de su enfermedad, sean tratados en unidades de cuidados intensivos, lo que no era frecuente hace dos décadas. Objetivo: Describir el desarrollo de la disfunción múltiple de órganos en pacientes pediátricos con leucemia linfoide aguda en terapia intensiva en el Instituto de Hematología e Inmunología. Métodos: Se realizó un estudio clínico, observacional, transversal en el que se incluyeron los pacientes pediátricos con leucemia linfoblástica aguda y disfunción múltiple de órganos, atendidos en el servicio de terapia intensiva en el periodo 2018 a 2020. Se analizaron las variables: sociodemográficas, estado nutricional, diagnóstico al ingreso, puntaje del score pSOFA, conducta fármaco-terapéutica. Resultados: El grupo de edad más afectado fue el de 1 a 4 años, en su mayoría normopesos, con complicaciones de choque séptico, distrés respiratorio, y con 33 por ciento de mortalidad mayor en aquellos pacientes con score pSOFA con más de 10 puntos. La conducta terapéutica más utilizada fue la administración de oxígeno, fluidoterapia y antibióticos de tercera y cuarta generación en la primera hora de ingreso al servicio. Conclusiones: Si el puntaje del score pSOFA es mayor de 10 puntos existe mayor riesgo de muerte y mortalidad pediátrica (90 por ciento )(AU)


Introduction: The prognosis of hematological malignancies has undergone an important advance in the last decades, mainly due to the new chemotherapy combinations. These facts have led many of these patients to be treated in intensive care units at some point during their illness. Objective: To describe the development of multiple organ dysfunction in pediatric patients with acute lymphoid leukemia in intensive care at the Institute of Hematology and Immunology. Methods: A clinical, observational, cross-sectional study was carried out that included pediatric patients with acute lymphoblastic leukemia and multiple organ dysfunction, treated in the intensive care service in the period from 2018 to 2020. The variables were analyzed: sociodemographic, nutritional status, diagnosis on admission, pSOFA score, drug-therapeutic behavior. Results: The most affected age group was 1 to 4 years old, mostly normal weight, with complications of septic shock, respiratory distress, and 33 percent higher mortality in those patients with a pSOFA score with more than 10 points. The most used therapeutic approach was the administration of oxygen, fluid therapy and third and fourth generation antibiotics in the first hour of admission to the service. Conclusions: If the pSOFA score is greater than 10 points, there is a greater risk of death and pediatric mortality (90 percent)(AU).


Subject(s)
Humans , Infant , Child, Preschool , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Organ Dysfunction Scores , Intensive Care Units , International Cooperation , Anti-Bacterial Agents , Cross-Sectional Studies
10.
Rev. cuba. invest. bioméd ; 40(2): e1104, 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1347458

ABSTRACT

Introducción: Las plantas medicinales han demostrado poseer propiedades antibacterianas para el control de la periodontitis. Objetivo: Determinar la actividad antibacteriana frente a Porphyromonas gingivalis ATCC 33277 de un gel experimental compuesto por aceite esencial de Eucalyptus globulus Labill. Métodos: Se realizó un estudio experimental in vitro. Se empleó el programa EPi InfoTM para el cálculo de las repeticiones. El aceite esencial se obtuvo por el método de arrastre de vapor; se identificó su composición química por cromatografía de gases acoplada a espectrometría de masas. Se evaluó la concentración mínima inhibitoria (CMI) y concentración mínima bactericida (CMB). Se realizó un ensayo de difusión en Agar para medir los halos de inhibición del gel experimental al 4,46 por ciento frente a P. gingivalis, la comparación con clorhexidina al 0,12 por ciento se evaluó con la prueba U de Mann-Whitney. Se adoptó un nivel de significancia del 5 por ciento . Resultados: Se identificaron 11 constituyentes en el aceite esencial, los principales componentes químicos fueron 3-heptadecene, (Z)- (36,13 por ciento ), 1-tridecene (14,7 por ciento ) y 1,8-cineole (9,72 por ciento ). La CMI del aceite esencial fue 36,195 mg/mL y la CMB fue 39,114 mg/mL. Los halos de inhibición del gel experimental de P. gingivalis fueron 25,533 mm ± 0,960. mm. Se observaron diferencias estadísticamente significativas frente a clorhexidina al 0,12 por ciento (23,282 ± 0,345) (p < 0,05). Conclusiones: El gel experimental al 4,46 por ciento compuesto por aceite esencial de Eucalyptus globulus Labill presentó una actividad antibacteriana importante frente a Porphyromonas gingivalis ATCC 33277(AU)


Introduction: Medicinal plants have proved to have antibacterial properties for the control of periodontitis. Objective: Determine the antibacterial activity against Porphyromonas gingivalis ATCC 33277 of an experimental gel composed of essential Eucalyptus globulus Labill oil. Methods: An in vitro experimental study was conducted. The software EPi InfoTM was used to estimate the repetitions. The essential oil was obtained by steam entrainment, and its chemical composition was determined by gas chromatography / mass spectrometry. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were also evaluated. An agar diffusion test was performed to measure the inhibition haloes of the 4.46 percent experimental gel against P. gingivalis. Comparison with 0.12 percent chlorhexidine was evaluated with the Mann-Whitney U test. A 5 percent significance level was adopted. Results: A total 11 constituents were identified in the essential oil. The main chemical components were 3-Heptadecene, (Z)- (36.13 percent), 1-Tridecene (14.7 percentand 1,8-cineole (9.72 percent). MIC of the essential oil was 36.195 mg/ml, whereas MBC was 39.114 mg/ml. The inhibition haloes of the experimental P. gingivalis gel were 25.533 mm ± 0.960 mm. Statistically significant differences were observed versus 0.12 percent chlorhexidine (23.282 ± 0.345) (p < 0.05). Conclusions: The 4.46 percent experimental gel composed of Eucalyptus globulus Labill essential oil displayed considerable antibacterial activity against Porphyromonas gingivalis ATCC 33277(AU)


Subject(s)
Humans , Male , Female , Periodontitis , Oils, Volatile , Chlorhexidine , Mass Spectrometry/methods , In Vitro Techniques , Microbial Sensitivity Tests , Chromatography, Gas/methods , Anti-Bacterial Agents/therapeutic use
11.
Cambios rev. méd ; 20(1): 21-25, 30 junio 2021. tabs.
Article in Spanish | LILACS | ID: biblio-1292703

ABSTRACT

INTRODUCCIÓN. La apendicitis aguda es una patología pediátrica quirúrgica que en su fase complicada requiere uso de antibióticos en el postoperatorio; encontrar la mejor opción como experiencia local, fue necesario. OBJETIVO. Comparar un esquema de antibioticoterapia triple vs un doble respecto a variables: demográficas, clínicas y de costos en pacientes pediátricos con apendicitis complicada. MATERIALES y MÉTODOS. Estudio analítico transversal. Población de 133 pacientes y una muestra de 93, operados por apendicitis complicada; 58 recibieron ampicilina + metronidazol + gentamicina y 35 ceftriaxona + metronidazol. Se comparó las variables: estadía hospitalaria, complicaciones y costo monetario de cada esquema. Se realizó en la Unidad de Cirugía Pediátrica del Hospital de Especialidades Carlos Andrade Marín, en el periodo enero de 2017 a octubre de 2018. Los datos fueron analizados con R-Studio 1.8.366 para Windows. RESULTADOS. No hubo diferencia estadística con respecto a: estadía hospitalaria (p=0,261); complicaciones como infección del sitio quirúrgico (p=0,196), re-intervención quirúrgica (p=0,653) y costo (p=0,059). CONCLUSIÓN. Se comparó el esquema de antibioticoterapia triple vs un doble, utilizados en apendicitis complicada en pediatría. No se encontró diferencias estadísticamente significativas en este reporte preliminar, con la diferencia de que con el esquema doble la frecuencia de administración fue menor y se evitó la exposición a los efectos colaterales de los aminoglicósidos.


INTRODUCTION. Acute appendicitis is a pediatric surgical pathology that in its complicated phase requires the use of antibiotics during the postoperative period; finding the best option as local experience was a must. OBJECTIVE. Compare a triple vs a double antibiotic therapy scheme respect demographic, clinical and cost variables in pediatric patients whit complicated apendicitis. MATERIALS AND METHODS. Cross-sectional analytical study. Population of 133 patients and sample of 93, with complicated appendicitis; 58 received ampicillin + metronidazole + gentamicin and 35 ceftriaxone + metronidazole. The following variables were compared; hospital stay, complications and monetary cost of each scheme. It was performed in the Pediatric Surgery Unit of the Hospital of Specialties Carlos Andrade Marin, during january 2017, through october 2018. The data were analyzed with R-Studio 1.8.366 for Windows. RESULTS. There was no statistical difference regarding hospital stay (p=0.261); complications such as surgical site infection (p=0.196), re-surgical intervention (p=0.653); nor cost (p=0.059). CONCLUSION. Triple vs. Double antibiotic therapy scheme used in complicated appendicitis in pediatrics was compared. No statistically significant differences were found in this preliminary report, how ever with the double scheme the frequency of administration was lower and exposure to side effects of aminoglycosides was avoided.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Appendicitis/complications , Gentamicins , Cephalexin , Ampicillin , Metronidazole , Anti-Bacterial Agents/therapeutic use , Pediatrics , Postoperative Complications , General Surgery , Cost-Benefit Analysis
12.
Cambios rev. méd ; 20(1): 10-14, 30 junio 2021. tabs.
Article in Spanish | LILACS | ID: biblio-1292684

ABSTRACT

INTRODUCCIÓN. Las infecciones del tracto urinario son causa de mayor morbilidad en la población adulta y afectan con frecuencia a la mujer. Al ser un problema prevalente, fue fundamental realizar estudios sobre perfiles de susceptibilidad locales para establecer medidas de vigilancia y control de uso de antibióticos. OBJETIVO. Determinar el perfil de farmacorresistencia microbiana en adultos con infección del tracto urinario. MATERIALES Y MÉTODOS. Estudio descriptivo, transversal. La población fue de 437 urocultivos y una muestra de 176 positivos con su antibiograma, realizados en el laboratorio del Hospital Básico de Sangolquí entre enero de 2017 hasta abril de 2018. Los criterios de inclusión fueron: pacientes mayores de 15 años de edad de ambos sexos, ambulatorios y hospitalizados, que presentaron urocultivos positivos definidos por una cuenta mayor a 100 000 Unidades Formadoras de Colonia. RESULTADOS. Del 40,27% (176; 437) de urocultivos positivos, la bacteria aislada con frecuencia fue Escherichia coli. 69,31% (122; 176), con resistencia a ampicilina 77,97% (92; 118), trimetropim-sulfametoxazole 62,26% (66; 106), norfloxacino 37,50% (42; 112), ciprofloxacino 35,65 % (41; 115), ampicilina/sulbactam 32,20% (38; 118) y con susceptibilidad a: fosfomicina, ceftriaxona, amikacina y nitrofurantoina. CONCLUSIÓN. Se determinó el perfil de farmacorresistencia microbiana en adultos con infección del tracto urinario; donde Escherichia coli. fue aislada con frecuencia, con susceptibilidad favorable para nitrofurantoína y fosfomicina.


INTRODUCTION. Urinary tract infections are the cause of greater morbidity in the adult population and it often affects women. As it is a prevalent problem, it was essential to carry out studies on local susceptibility profiles to establish surveillance measures and control of antibiotic use. OBJECTIVE. To determine the microbial drug resistance profile in adults with urinary tract infection. MATERIALS AND METHODS. Descriptive, cross-sectional study. The population was 437 urine cultures and a sample of 176 positive with their antibiogram, carried out in the laboratory of the Hospital Básico de Sangolquí between january 2017 and april 2018. Inclusion criteria were: patients older than 15 years of age of both sexes, ambulatory and hospitalized, who presented positive urine cultures defined by a count greater than 100 000 Colony Forming Units. RESULTS. Of the 40,27% (176; 437) of positive urine cultures, the bacterium frequently isolated was Escherichia coli. 69,31% (122; 176), with resistance to ampicillin 77,97% (92; 118), trimethoprim-sulfamethoxazole 62,26% (66; 106), norfloxacin 37,50% (42; 112), ciprofloxacin 35,65% (41; 115), ampicillin / sulbactam 32,20% (38; 118) and with susceptibility to: fosfomycin, ceftriaxone, amikacin and nitrofurantoin. CONCLUSION. The microbial drug resistance profile was determined in adults with urinary tract infection; where Escherichia coli. was frequently isolated, with favorable susceptibility to nitrofurantoin and fosfomycin.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Urinary Tract , Urinary Tract Infections , Drug Resistance, Microbial , Anti-Bacterial Agents , Staphylococcus , Bacteriuria , Ampicillin Resistance , Microbial Sensitivity Tests , Drug Resistance, Bacterial , Escherichia coli
13.
Rev. inf. cient ; 100(3): e3500, 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1289645

ABSTRACT

Introducción: La evolución espontánea o los casos mal tratados de la úlcera corneal conllevan el riesgo de extensión de la infección, con severa afectación visual e integridad estructural del ojo. Objetivo: Describir las características clínico-epidemiológicas de pacientes con úlcera corneal grave bacteriana tratada con ozonoterapia local coadyuvante al tratamiento protocolizado. Método: Se realizó un estudio observacional, descriptivo y transversal con 48 pacientes ingresados en el servicio de Oftalmología del Hospital General Docente "Dr. Juan Bruno Zayas Alfonso", de Santiago de Cuba, en el periodo de enero de 2017 a diciembre de 2019. Las variables del estudio fueron: edad, sexo, factores predisponentes, microorganismos, signos de mejoría clínica, resultados al tratamiento y complicaciones. Para la validación estadística se utilizó prueba Chi-cuadrado. Resultados: La edad promedio de los pacientes fue de 54,1 años, el 62,5 % eran hombres. Predominó el trauma ocular (63,3 %) en el sexo masculino y enfermedades oculares (44,4 %) en el femenino. La mejoría de los signos fue más representativa a los 14 días. Se logró resultados satisfactorios en el 100 % de los pacientes con microorganismos grampositivos. El 10,4 % presentó perforación corneal. Conclusiones: La ozonoterapia es una terapia válida como tratamiento en la úlcera corneal grave de etiología bacteriana y responde a la búsqueda de alternativas para pacientes con resistencia a los tratamientos antibacterianos que se ofertan en el cuadro básico de salud.


ABSTRACT Introduction: Spontaneous evolution or poorly treated cases of corneal ulcer carry the risk of extension of the infection, with severe visual impairment and damage to the structural integrity of the eye. Objective: To describe the clinical-epidemiological characteristics of patients with severe bacterial corneal ulcer treated with local ozone therapy as an adjunct to the standard protocol treatment. Method: An observational, descriptive and cross-sectional study was carried out on 48 patients admitted to the Ophthalmology service of the Hospital General Docente "Dr. Juan Bruno Zayas Alfonso", from Santiago de Cuba, in the period from January 2017 to December 2019. The study variables were: age, gender, predisposing factors, microorganisms, signs of clinical improvement, treatment results and complications. Chi-square test was used for statistical validation. Results: The average age of the patients was 54.1 years; 62.5% of them were men. Ocular trauma (63.3%) predominated in males, and ocular diseases (44.4%) in females. The improvement of the signs was more common after 14 days. Satisfactory results were achieved in 100% of patients with gram-positive organisms. 10.4% presented corneal perforation. Conclusions: Ozone therapy is valid as a treatment for severe corneal ulcer of bacterial etiology, and responds to the search for alternatives for patients with resistance to the antibacterial treatments that are offered in the basic health system.


RESUMO Introdução: A evolução espontânea ou casos mal tratados de úlcera de córnea trazem o risco de extensão da infecção, com comprometimento visual grave e integridade estrutural do olho. Objetivo: Descrever as características clínico-epidemiológicas de pacientes com úlcera bacteriana de córnea grave tratados com ozonioterapia local como coadjuvante ao tratamento protocolizado. Método: Foi realizado um estudo observacional, descritivo e transversal com 48 pacientes internados no serviço de Oftalmologia do Hospital General Docente "Dr. Juan Bruno Zayas Alfonso", de Santiago de Cuba, no período de janeiro de 2017 a dezembro de 2019. As variáveis do estudo foram: idade, sexo, fatores predisponentes, microrganismos, sinais de melhora clínica, resultados do tratamento e complicações. O teste do qui-quadrado foi usado para validação estatística. Resultados: A idade média dos pacientes foi de 54,1 anos, 62,5% eram homens. O trauma ocular (63,3%) predominou no sexo masculino e as doenças oculares (44,4%) no feminino. A melhoria da sinalização foi mais representativa aos 14 dias. Resultados satisfatórios foram alcançados em 100% dos pacientes com organismos gram-positivos. 10,4% apresentaram perfuração corneana. Conclusões: A ozonioterapia é uma terapia válida como tratamento para úlcera de córnea grave de etiologia bacteriana e responde à busca de alternativas para pacientes com resistência aos tratamentos antibacterianos que são oferecidos no quadro básico de saúde.


Subject(s)
Humans , Male , Female , Middle Aged , Ozone/therapeutic use , Eye Infections, Bacterial/etiology , Eye Infections, Bacterial/microbiology , Corneal Ulcer/complications , Corneal Ulcer/diagnosis , Corneal Ulcer/etiology , Epidemiology, Descriptive , Cross-Sectional Studies , Observational Study , Anti-Bacterial Agents
14.
Braz. dent. j ; 32(3): 10-20, May-June 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1345504

ABSTRACT

Abstract The host defense response to microbial challenge emerging from the root canal system leads to apical periodontitis. The aim of this study was to evaluate the expression of inflammatory cytokines and Nitric Oxide (NO) by macrophages after interaction with Enterococcus faecalis in the: plankton and dislodged biofilm mode; intact biofilm mode stimulated by calcium hydroxide (CH), CH and chlorhexidine (CHX) or Triple Antibiotic Paste (TAP). For this purpose, culture of macrophages from monocytes in human peripheral blood (N=8) were exposed to the different modes of bacteria for 24 hours. Subsequently, the cytokines, such as, Tumor Necrotic Factor- alfa (TNF-α), interleukin (IL)-1β, IL-6, IL-10; and NO were quantified by Luminex xMAP and Greiss reaction, respectively. In addition to the potential therapeutic effects of the intracanal medication, their antimicrobial activity against Enterococcus faecalis biofilm were also tested in vitro by confocal microscopy. The experiments` data were analyzed by the Kruskal-Wallis test with the Dunn post hoc test (α < 0.05). Bacteria in dislodged biofilm mode were shown to be more aggressive to the immune system than bacteria in plankton mode and negative control, inducing greater expression of NO and TNF-α. Relative to bacteria in intact biofilm mode, the weakest antimicrobial activity occurred in Group CH. In Groups CH/CHX and TAP the percentage of dead bacteria was significantly increased to the same extent. Interestingly, the biofilm itself did not induce the release of pro-inflammatory cytokines - except for NO - while the biofilm treated with TAP and CH based pastes enhanced the levels of IL-6 and TNF-α; and IL-1 β, respectively. In contrast, the levels of a potent anti-inflammatory (IL-10) were increased in Group TAP.


Resumo A resposta de defesa do hospedeiro ao desafio microbiano que emerge do sistema de canais radiculares leva à periodontite apical. Os objetivos deste estudo foram avaliar a expressão de citocinas pró e anti-inflamatórias e Óxido Nítrico (NO) por macrófagos após interação com Enterococcus faecalis no modo: planctônio e de biofilme desalojado; biofilme intacto estimulado por hidróxido de cálcio (CH), CH e clorexidina ou Pasta Tri Antibiótica (TAP). Para isto, a cultura de macrófagos originados de monócitos do sangue periférico de humanos (N=8) foi exposta aos diferentes tipos de bactéria por 24 horas. Então, a quantificação da produção de of Fator de Necrose Tumoral- alfa (TNF-α), interleucina (IL)-1β, IL-6, IL-10 e NO por macrófagos se deu por meio do Luminex xMAP e reação de Greiss, respectivamente. Além dos potenciais efeitos terapêuticos desses compostos, sua atividade antimicrobiana contra E. faecalis também foi testada através microscopia confocal. Os dados dos experimentos foram analisados através do teste de Kruskal-Wallis com Dunn`s post hoc (α < 0.05). Bactéria em modo de biofilme desalojado se mostrou mais agressivo ao sistema imune que as bactérias planctônicas e controle negativo induzindo a maior excreção de NO e TNF-α. Em relação ao biofilme intacto, a atividade antimicrobiana mais fraca ocorreu no grupo de CH. Os grupos CHX e TAP aumentaram significativamente a porcentagem de bactérias mortas na mesma extensão. Interessantemente, o biofilme por ele mesmo não induziu a liberação de citocinas pro-inflamatórias - exceto por NO - enquanto que o biofilme tratado com TAP ou pastas a base de CH aumentaram os níveis de IL-6; e TNF-α e IL-1 β respectivamente. Em contraste, os níveis da potente citocina anti-inflamatória (IL-10) foram aumentados pelo grupo TAP.


Subject(s)
Humans , Plankton , Biofilms , Root Canal Irrigants , Bacteria , Calcium Hydroxide , Chlorhexidine , Enterococcus faecalis , Anti-Bacterial Agents
15.
Medisur ; 19(3): 477-491, 2021. graf
Article in Spanish | LILACS | ID: biblio-1287329

ABSTRACT

RESUMEN La introducción de los antibióticos en el siglo pasado ha sido uno de los ejemplos que brinda la historia de intervenciones médicas que cambiaron drásticamente la esperanza de vida de la población. La época dorada de los antibióticos, cuando la aparición de nuevas moléculas era lo habitual, ha dado paso a otra de sequía, en la que es raro el desarrollo de este grupo farmacológico debido al largo período de tiempo que requieren las investigaciones de nuevos fármacos, su elevado costo y al aumento de las exigencias regulatorias. Este progreso médico ganado en décadas pasadas, está amenazado por el aumento de la resistencia de las bacterias a los antibióticos; constituye un grave riesgo mundial por lo que requiere una mayor atención y la coherencia a nivel internacional, nacional y regional. La resistencia bacteriana tiene un gran impacto microbiológico, terapéutico, económico, epidemiológico y en la salud pública; cuesta dinero, medios de subsistencia, vidas humanas y amenaza con socavar la eficacia de los programas de atención a la salud. La presente revisión bibliográfica propone reflexionar sobre los aspectos más significativos del desarrollo de los antibióticos y su impacto en la sociedad.


ABSTRACT The introduction of antibiotics in the last century has been one of the examples that history provides of medical interventions that drastically changed the life expectancy of the population. The golden age of antibiotics, where the appearance of new molecules was what usual, has given way to another of drought, in which the development of this pharmacological group is rare due to the long period of time required for research into new drugs, their high cost and the increase in regulatory requirements. This medical progress gained in past decades is threatened by the increase in the resistance of bacteria to antibiotics, constituting a serious global risk for which it requires greater attention and coherence at the international, national and regional levels. Bacterial resistance has a great microbiological, therapeutic, economic, epidemiological and public health impact; it costs money, livelihoods, human lives, and threatens to undermine the effectiveness of health care programs. This bibliographic review proposes to reflect on the most significant aspects of the development of antibiotics and their impact on society.


Subject(s)
Humans , Drug Resistance, Microbial/drug effects , Drug Resistance, Bacterial/drug effects , Anti-Bacterial Agents/therapeutic use , Health Policy/trends
16.
Infectio ; 25(2): 101-107, abr.-jun. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1250075

ABSTRACT

Resumen Objetivo: Estimar la resistencia del Staphylococcus aureus frente a diferentes antibióticos usados para el manejo ambulatorio de piodermias. Métodos: Se realizaron análisis descriptivos y de tendencias mediante modelos de regresión segmentada. Resultados: La mayor resistencia se presentó a la oxacilina, con mediana de 54,3% (RIQ: 43 - 58,8), seguido de eritromicina con el 20%, (RIQ: 15,4 - 26,5), clindami cina con el 14% (RIQ: 7,9 - 20), gentamicina con el 7,5% (RIQ: 0 -10), trimetoprima/sulfametoxazol (SXT) con el 5,5% (RIQ: 4 - 11), y ciprofloxacina con 2,1% (RIQ: 2 - 8.4). La tendencia de la resistencia del S. aureus a la oxacilina fue creciente con un cambio anual porcentual no significativo de (0,07) (IC 95%: -3,7; 3,9). Para eritromicina, clindamicina, ciprofloxacina, trimetoprima/sulfametoxazol, y gentamicina hubo decrecimiento. Conclusiones: La resistencia del S. aureus a oxacilina fue ligeramente creciente para el periodo 2010 al 2019 y francamente creciente en los últimos 3 años, superando en promedio a lo reportado a nivel país y Latinoamérica. Los antibióticos con menor resistencia fueron ciprofloxacina, SXT, clindamicina para uso sistémico, y ácido fusídico, mupirocina para manejo tópico y descolonización. Es pertinente articular la vigilancia del S. aureus en la atención ambulatoria a la red de vigilancia nacional.


Abstract Objective: To estimate the resistance trend of Staphylococcus aureus (S. aureus) against different antibiotics in a reference dermatology outpatient center in Colombia. Methods: Descriptive and trend analyzes were performed using segmented regression models for the period 2010 to 2019. Results: The greatest resistance was presented to oxacillin, with a median of 54.3% (RIQ: 43 - 58.8), followed by erythromycin with 20%, (RIQ: 15.4 - 26.5), then clindamycin with 14% (RIQ: 7.9 - 20), gentamicin with 7.5% (RIQ: 0 -10), trimethoprim / sulfamethoxazole (SXT) with 5.5% (RIQ: 4 - 11), and ciprofloxacin with 2.1% (RIQ: 2 - 8.4). The trend of S. aureus resistance to oxacillin from 2010 to 2019 was increasing with a non-significant Annual Percent Change (APC) of (0.07) (95% CI -3.7, 3.9). APC for erythromycin (-1.2) (95% CI: -11.3; 10), clindamycin (-1.7) (95% CI: 11; -12.9), ciprofloxacin (-25.4) (95% CI: -44.6; 0.5) and trimethoprim / sul famethoxazole (-20.7) (95% CI: -43.5; 11.2), were decreasing not significant. For gentamicin the trend was decreasing and significant (-44.2) (95% CI: -19.9; -61.1). Conclusions: The resistance of S. aureus to oxacillin exhibited a slightly increasing trend for the period 2010 to 2019 and increasing in the last 3 years, exceeding on average that reported at the country level and the world average. Antibiotics for outpatient management of skin and soft tissue pyoderma with less resistance were ciprofloxacin, SXT, clindamycin for systemic use, and fusidic acid, mupirocin for topical management and decolonization. It is important to articulate surveillance of S. aureus in outpatient care to the national surveillance network.


Subject(s)
Humans , Male , Adult , Middle Aged , Dermatology , Methicillin-Resistant Staphylococcus aureus , Staphylococcus aureus , Sulfamethoxazole , Gentamicins , Ciprofloxacin , Fusidic Acid , Anti-Bacterial Agents
17.
Electron. j. biotechnol ; 51: 67-78, May. 2021. graf, tab
Article in English | LILACS | ID: biblio-1343435

ABSTRACT

BACKGROUND: Endometritis is the most common disease of dairy cows and traditionally treated with antibiotics. Lactic acid bacteria can inhibit the growth of pathogens and also have potential for treatment of endometritis. Using PacBio single-molecule real-time sequencing technology, we sequenced the fulllength l6S rRNA of the microbiota in uterine mucus samples from 31 cows with endometritis, treated with lactic acid bacteria (experimental [E] group) and antibiotics (control [C] group) separately. Microbiota profiles taken before and after treatment were compared. RESULTS: After both treatments, bacterial species richness was significantly higher than before, but there was no significant difference in bacterial diversity. Abundance of some bacteria increased after both lactic acid bacteria and antibiotic treatment: Lactobacillus helveticus, Lactococcus lactis, Lactococcus raffinolactis, Pseudomonas alcaligenes and Pseudomonas veronii. The bacterial species that significantly decreased in abundance varied depending on whether the cows had been treated with lactic acid bacteria or antibiotics. Abundance of Staphylococcus equorum and Treponema brennaborense increased after lactic acid bacteria treatment but decreased after antibiotic treatment. According to COG-based functional metagenomic predictions, 384 functional proteins were significantly differently expressed after treatment. E and C group protein expression pathways were significantly higher than before treatment (p < 0.05). CONCLUSIONS: In this study, we found that lactic acid bacteria could cure endometritis and restore a normal physiological state, while avoiding the disadvantages of antibiotic treatment, such as the reductions in abundance of beneficial microbiota. This suggests that lactic acid bacteria treatment has potential as an alternative to antibiotics in the treatment of endometritis in cattle.


Subject(s)
Animals , Female , Cattle , Cattle Diseases/drug therapy , Endometritis/drug therapy , Lactobacillales/metabolism , High-Throughput Nucleotide Sequencing/methods , Anti-Bacterial Agents/administration & dosage , Bacteria/isolation & purification , Bacteria/growth & development , Bacteria/drug effects , Uterus/microbiology , RNA, Ribosomal, 16S/genetics , Lactic Acid , Lactobacillales/genetics , Microbiota
18.
Bol. latinoam. Caribe plantas med. aromát ; 20(3): 260-269, may. 2021. tab
Article in English | LILACS | ID: biblio-1342820

ABSTRACT

The aim of this study was to undertake a screening experiment on essential oils (EO) of Myrcia lundiana, Ocimum basilicum and Lippia alba against six food-spoiling pathogenic bacteria. Seventy-two (72) samples were initially analyzed fo antimicrobial activity based on the agar diffusion test. The minimum inhibitory (MIC) and bactericidal (MBC) concentrations were determined for the 12 samples which showed greatest antimicrobial potential in this stage. Two samples of L. alba, three samples of M. lundiana and seven samples of O. basilicum showed a MIC of 0.12-125 µL/mL for the six tested bacteria. Of these, the EO of O. basilicum cultivar Maria Bonita stood out with the lowest MIC and MBC. Thus, a mixture simulating this essential oil was prepared from commercial standards of the compounds (±)-linalool, geraniol and 1,8-cineole. Significantly higher MIC and MBC were detected in the simulation compared to the respective EO, suggesting a synergistic effect between compounds.


El objetivo de este estudio fue realizar un experimento de detección en aceites esenciales (AE) de Myrcia lundiana, Ocimum basilicum y Lippia alba contra seis bacterias patógenas que estropean los alimentos. Setenta y dos (72) muestras fueron analizadas inicialmente para la actividad antimicrobiana basada en la prueba de difusión en agar. Se determinaron las concentraciones mínimas inhibitoria (CMI) y bactericida (CMB) para las 12 muestras que mostraron el mayor potencial antimicrobiano en esta etapa. Dos muestras de L. alba, tres muestras de M. lundiana y siete muestras de O. basilicum mostraron un CMI de 0.12-125 µL/mL para las seis bacterias analizadas. De estos, el AE de O. basilicum cultivar Maria Bonita se destacó con el CMI y CMB más bajos. Por lo tanto, se preparó una mezcla que simula este aceite esencial a partir de los estándares comerciales de los compuestos de (±)-linalol, geraniol y 1,8-cineol. Se detectaron CMI y CMB significativamente más altos en la simulación en comparación con el AE respectivo, lo que sugiere un efecto sinérgico entre los compuestos.


Subject(s)
Bacteria/drug effects , Oils, Volatile/pharmacology , Ocimum basilicum/chemistry , Myrtaceae/chemistry , Lippia/chemistry , Anti-Bacterial Agents/pharmacology , Sesquiterpenes/analysis , Oils, Volatile/chemistry , Microbial Sensitivity Tests , Food , Anti-Bacterial Agents/chemistry
19.
Rev. cuba. angiol. cir. vasc ; 22(1): e181, ene.-abr. 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1251681

ABSTRACT

Introducción: Las úlceras flebostáticas constituyen una patología importante en la práctica médica diaria en todos los niveles de asistenciales; después del dolor y del edema, las úlceras de los miembros inferiores representan el tercer problema más común en las consulta de angiología. Objetivo: Caracterizar los gérmenes bacterianos aislados con frecuencia en las úlceras flebostáticas de los pacientes ingresados. Métodos: Se realizó un estudio descriptivo retrospectivo de corte transversal en 60 pacientes ingresados por diagnóstico de úlceras flebostáticas entre julio de 2016 y junio de 2017. A todos se les hizo cultivo microbiológico de la lesión con el respectivo antibiograma. Se tuvieron en cuenta las variables: tipo de úlcera flebostática, gérmenes bacterianos aislados, antibióticos analizados in vitro y patrón de sensibilidad antibiótica. Se calcularon las frecuencias absolutas y relativas. Resultados: Se encontró un predominio de úlceras varicosas (67 por ciento). El germen bacteriano que más se aisló fue Pseudomas spp. (41,7 por ciento), con más frecuencia en las úlceras varicosas que en las postrombóticas (47,5 por ciento vs. 30 por ciento). Los mejores porcentajes de sensibilidad in vitro se mostraron ante los siguientes antibióticos: Clindamicina (100 por ciento), Tobramicina (79,2 por ciento), Ciprofloxacino (78,4 por ciento), Amikacina (68,4 por ciento), Cotrimoxazol (68,2 por ciento), Cefepime (67,6 por ciento), Doxiciclina (66,7 por ciento), Cloranfenicol (60 por ciento), Meropenem (62,1 por ciento), Penicilina G (57 por ciento) y Aztreonam (55,9 por ciento). Conclusiones: Pseudomas spp. fue el germen bacteriano que más se aisló en los pacientes con úlceras varicosas y postrombóticas; además, se manifestó sensibilidad a 11 de los 23 antibióticos que se probaron in vitro en más del 50 por ciento de los aislados a los que se enfrentaron(AU)


Introduction: Phlebostatic ulcers are an important pathology in daily medical practice at all levels of care; after pain and edema, lower limb ulcers are the third most common problem in angiology consultations. Objective: Characterize frequently isolated bacterial germs in the phlebostatic ulcers of admitted patients. Methods: A descriptive, cross-sectional, retrospective study was conducted in 60 patients admitted due to a diagnosis of phlebostatic ulcers from July 2016 to June 2017. It was made a microbiological cultivation of the lesion with the respective antibiogram to all the patients. Variables were taken into account, like: type of phlebostatic ulcer, isolated bacterial germs, antibiotics tested in vitro and antibiotic sensitivity pattern. The absolute and relative frequencies were calculated. Results: A predominance of varicose ulcers (67 percent) was found. The most isolated bacterial germ was Pseudomasspp. (41.7 percent), and it was more often in varicose ulcers than in post-thrombotic ulcers (47.5 percent vs. 30 percent). The best percentages of in vitro sensitivity were shown against the following antibiotics: Clindamycin (100 percent), Tobramycin (79.2 percent), Ciprofloxacin (78.4 percent), Amikacin (68.4 percent), Cotrimoxazol (68.2 percent), Cefepime (67.6 percent), Doxycycline (66.7 percent), Chloramphenicol (60 percent), Meropenem (62.1 percent), Penicillin G (57 percent), Aztreonam (55.9 percent). Conclusions: Pseudomasspp. was the most isolated bacterial germ in patients with varicose and post-thrombotic ulcers; in addition, sensitivity was present in 11 of the 23 antibiotics that were tested in vitro in more than 50 percent of the isolates they faced(AU)


Subject(s)
Humans , Male , Female , Ulcer , Varicose Ulcer , Retrospective Studies , Methods , Anti-Bacterial Agents
20.
Rev. bras. ortop ; 56(2): 268-270, Apr.-June 2021. tab, graf
Article in English | LILACS | ID: biblio-1251343

ABSTRACT

Abstract Septic arthritis of the pubic symphysis is a rare condition. Risk factors include trauma, low-grade infection, urological or gynecological procedures, malignant tumors of the pelvis, sports, and intravenous drug abuse. This report describes a case of septic arthritis of the pubic symphysis in a 23-year-old male patient with no history of pelvic surgery, previous infections, or intense physical activity. Arthritis was diagnosed by blood culture positive for Enterococcus spp. and yeasts, and the patient was treated with antibiotics. This case emphasizes the importance of complementary exams to aid the treatment of septic arthritis of the pubic symphysis and shows that an invasive procedure, such as pubic symphysis puncture biopsy, may not be required.


Resumo A artrite séptica da sínfise púbica é uma condição rara. Os fatores de risco são trauma, infecção de baixo grau, procedimentos urológicos ou ginecológicos, tumores malignos da pelve, prática de esportes e uso de drogas intravenosas. O presente relato descreve um caso de artrite séptica da sínfise púbica em um paciente do sexo masculino, de 23 anos, sem história de cirurgias pélvicas, infecções prévias ou atividade física intensa. A artrite foi diagnosticada pela hemocultura que revelou crescimento de Enterococcus sp + leveduras, e o paciente foi tratado com antibioticoterapia. Este caso enfatiza a importância de exames complementares no auxílio do tratamento da artrite séptica da sínfise púbica, e demonstra que procedimentos invasivos, tais como a punção da sínfise púbica, podem não ser necessários.


Subject(s)
Humans , Male , Adult , Osteitis , Pubic Symphysis , Arthritis, Infectious , Enterococcus , Anti-Bacterial Agents
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