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3.
Int. j. med. surg. sci. (Print) ; 8(2): 1-15, jun. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1284390

ABSTRACT

La importancia de la evaluación inicial de la gravedad del paciente con neumonía es una acción diagnóstica de importancia bien establecida. El objetivo del trabajo fue evaluar la relación entre la frecuencia y calidad del proceso de estratificación de pacientes con neumonía, y el cumplimiento de las sugerencias de ubicación intrahospitalaria y de tratamiento antimicrobiano inicial de un instrumento de estratificación. Se realizó un estudio descriptivo sobre una población de 1,809 pacientes hospitalizados durante 10 años. Se analizó el comportamiento de los índices de ubicación intrahospitalaria y tratamiento antimicrobiano inicial acorde a la sugerencia de un instrumento de estratificación utilizado; en el análisis estadístico se utilizó el Odds ratio y el estadígrafo X2, con un nivel de significación de 95%. En los resultados se destacan que la ubicación intrahospitalaria estuvo acorde a la sugerencia del instrumento en el 96%, con el valor más bajo en los pacientes con neumonía grave y altas probabilidades de recuperación (82%, p<,05). Se constató mayor frecuencia de ubicación intrahospitalaria acorde a la sugerencia del instrumento en los pacientes bien estratificados (p<,05), fundamentalmente en los pacientes con neumonía grave y altas probabilidades de recuperación. La correspondencia del tratamiento antimicrobiano inicial con la propuesta del instrumento fue del 61%; el estrato IIIA mostró el valor más elevado (80%, p<,05). Como conclusiones del estudio se constató un elevado desempeño en el cumplimiento de la sugerencia de ubicación intrahospitalaria del instrumento de estratificación, no así en el cumplimiento de la sugerencia de tratamiento antimicrobiano inicial. Se demostró la existencia de una relación entre el proceso de estratificación y el cumplimiento de la ubicación intrahospitalaria sugerida por el instrumento empleado.


The initial evaluation of the patient's condition with pneumonia is a very important assistance action. The objective was evaluate the relationship between the frequency and quality of the stratification process of the patient with pneumonia, and the execution of suggestions of intrahospitalary location and the initial antimicrobial treatment of stratification instrument. A descriptive study was done on a population of 1,809 patients hospitalized during 10 years. The indexes of intrahospitalary location and of antimicrobian initial treatment were analized according to the suggestions of the instrument; in the statistical analysis it was used the odds ratio and the statistician X2, with a significant level of 95%. The intrahospitalary location was in agreement with the suggestion of the instrument in 96% of the cases, with the lowest value in patients with serious pneumonia and high recovery probabilities (82%, p <,05). The frequency of intrahospitalary location was bigger and veryfied with the suggestion of the instrument in the termed well stratified patients (p <,05), fundamentally in the patients with serious pneumonia and high recovery probabilities. The correspondence of the initial antimicrobial treatment with the proposal of the instrument was of 61%; the stratum IIIA showed the highest value (80%, p <,05). As conclusions, a high performance in the execution of the suggestion of the intrahospitalary location has been one of the characteristics of the process, although as a negative element it stands out the frequent non-fulfillment of the suggestion of the initial antimicrobial treatment. There was a relationship between the stratification process and the execution of the suggestion of the intrahospitalary location.


Subject(s)
Humans , Patient Admission/statistics & numerical data , Pneumonia/diagnosis , Pneumonia/drug therapy , Community-Acquired Infections/diagnosis , Community-Acquired Infections/drug therapy , Anti-Infective Agents/therapeutic use , Severity of Illness Index , Quality Management , Cuba , Patient Acuity , Hospitalization/statistics & numerical data
4.
Rev. cuba. med. trop ; 73(1): e519, tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1280327

ABSTRACT

Introducción: El cólera es una infección intestinal aguda causada por cepas toxigénicas de Vibrio choleare. La rápida diseminación y emergencia de la multirresistencia que caracteriza a este patógeno, podría interferir en el éxito de la terapia antimicrobiana, por lo que constituye una prioridad monitorear los cambios en los patrones de susceptibilidad, como parte trascendental de la política de control de la resistencia antimicrobiana. Objetivo: Determinar el comportamiento de la resistencia antimicrobiana frente a los antimicrobianos de interés empleados en el tratamiento, la presencia de factores de virulencia enzimáticos y si existe relación entre ambos. Métodos: Se realizó un estudio descriptivo de corte transversal durante julio de 2012 a diciembre de 2015. Se estudiaron 500 aislamientos pertenecientes al cepario del Laboratorio Nacional de Referencia de Enfermedades Diarreicas Agudas del Instituto de Medicina Tropical Pedro Kourí, procedentes de brotes de enfermedades diarreicas agudas de la red nacional de laboratorios de Microbiología de Cuba. Se aplicaron métodos convencionales fenotípicos para determinar el comportamiento de la resistencia antimicrobiana, la presencia de factores enzimáticos y la relación de estos con la resistencia antimicrobiana. Resultados: Los mayores porcentajes de sensibilidad se obtuvieron frente a azitromicina (98 por ciento), doxiciclina (96 por ciento) y ciprofloxacina (93 por ciento) y de resistencia frente a ampicilina (100 por ciento) y trimetoprim-sulfametoxazol (99,4 por ciento). Se encontraron 44 aislados (8,8 por ciento) multirresistente. Todos los aislamientos poseían al menos dos enzimas extracelulares como factores de virulencia, las más frecuentes: gelatinasa (96 por ciento) y lecitinasa (95 por ciento). Conclusiones: Se evidencia una relación directa y proporcional entre la presencia de los factores de virulencia y resistencia antimicrobiana, sinergismo que surgiere mayor patogenicidad de los aislados estudiados procedentes de brotes epidémicos(AU)


Introduction: Cholera is an acute intestinal infection caused by toxigenic strains of Vibrio choleare. The rapid dissemination and emergence of the multiresistance that characterizes this pathogen could interfere with the success of antimicrobial therapy, so it is a priority to monitor changes in susceptibility patterns, as a transcendental part of the resistance control policy antimicrobial. Objective: To determine the behavior of antimicrobial resistance against the antimicrobials of interest used in the treatment, the presence of enzymatic virulence factors and whether there is a relationship between them. Methods: A descriptive cross-sectional study was conducted during July 2012 to December 2015. Where 500 isolates belonging to the cepary of the National Reference Laboratory for Acute Diarrheal Diseases of the Institute of Tropical Medicine Pedro Kourí, from outbreaks of EDA of the national network of Microbiology laboratories in Cuba. Conventional phenotypic methods were applied to determine the behavior of antimicrobial resistance, the presence of enzymatic factors and their relationship with antimicrobial resistance. Results: The highest percentages of sensitivity were obtained against azithromycin (98 percent), doxycycline (96 percent) and ciprofloxacin (93 percent) and resistance to ampicillin (100 percent) and trimethoprim-sulfamethoxazole (99.4 percent). 44 isolated (8.8 percent) multi-resistant were found. All isolates had at least two extracellular enzymes as virulence factors, the most frequent: gelatinase (96 percent) and lecithinase (95 percent). Conclusions: There is a direct and proportional relationship between the presence of virulence factors and antimicrobial resistance, synergism that arises greater pathogenicity of the isolates studied from epidemic outbreaks(AU)


Subject(s)
Humans , Vibrio cholerae/isolation & purification , Virulence Factors/analysis , Epidemiology, Descriptive , Cross-Sectional Studies , Anti-Infective Agents/therapeutic use
5.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 13: 757-762, jan.-dez. 2021. graf, tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1222817

ABSTRACT

Objective:To identify the prevalence of klebsiella pneumoniae and to analyze the factors related to the infection by this bacterium in a private hospital in northeastern Brazil. Method: descriptive retrospective documentary study, carried out with patients who developed infection in the year 2017 (n: 64). Sociodemographic and infection information was collected. The data was processed in SPSS 20.0. The project was approved by the ethics committee. Results: the most prevalent topographic site was the urinary tract (34; 56.7%). the main risk factor for triggering klebsiella pneumoniae infection was the use of mechanical ventilation, presenting a risk of 43.8% for the appearance of infections by this microorganism. Higher resistance was found for the piperacillin / tazobactam 52 antimicrobial (82.5%). Conclusion: because of the high resistance to antibiotics and the great potential of klebsiella contamination, measures should be taken to minimize the high level of contamination and, especially, the negative prognosis for the patient


Objetivo: Identificar a prevalência de Klebsiella pneumoniae e analisar os fatores relacionados à infecção por essa bactéria em hospital privado do nordeste brasileiro. Método: estudo descritivo retrospectivo documental, realizado com pacientes que desenvolveram infecção no ano de 2017 (n:64). Coletou-se informações sociodemográficas e referentes a infecção. Os dados foram processados no SPSS 20.0. O projeto foi aprovado pelo comitê de ética. Resultados: o sítio topográfico mais prevalente foi o trato urinário (34;56,7%). o principal fator de risco para desencadear infecção por Kebsiella pneumoniae foi a utilização de ventilação mecânica, apresentando risco de 43,8% para o aparecimento de infecções por esse microrganismo. Maior resistência foi encontrada para o antimicrobiano piperacilina/tazobactam 52 (82,5%). Conclusão: pela alta resistência aos antibióticos e o grande potencial de contaminação da klebsiella, medidas devem ser adotadas para minimizar o alto nível de contaminação e, principalmente do prognóstico negativo para paciente


Objetivo: Identificar la prevalencia de klebsiella pneumoniae y analizar los factores relacionados con la infección por esta bacteria en un hospital privado en el noreste de Brasil. Método: estudio descriptivo retrospectivo, realizado con pacientes que desarrollaron infección en el año 2017 (n: 64). Se recogió información sociodemográfica y de infección. Los datos fueron procesados en SPSS 20.0. El proyecto fue aprobado por el comité de ética. Resultados: el sitio topográfico más prevalente fue el tracto urinario (34; 56,7%). El principal factor de riesgo para desencadenar la infección por Klebsiella pneumoniae fue el uso de ventilación mecánica, que presenta un riesgo del 43.8% por la aparición de infecciones por este microorganismo. Se encontró una mayor resistencia para el antimicrobiano piperacilina / tazobactam 52 (82.5%). Conclusión: debido a la alta resistencia a los antibióticos y al gran potencial de contaminación por klebsiella, se deben tomar medidas para minimizar el alto nivel de contaminación y, especialmente, el pronóstico negativo para el paciente


Subject(s)
Humans , Male , Female , Infection Control/statistics & numerical data , Klebsiella pneumoniae/drug effects , Anti-Infective Agents/therapeutic use , Anti-Bacterial Agents/therapeutic use , Piperacillin/therapeutic use , Urinary Tract/microbiology , Prevalence , Risk Factors , Hospitals, Private , Tazobactam/therapeutic use
6.
Rev. cuba. med. trop ; 72(3): e605, sept.-dic. 2020. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1156539

ABSTRACT

Introducción: Escherichia coli extraintestinal constituye uno de los principales patógenos causantes de infecciones asociadas a la asistencia sanitaria con un alto impacto en la salud por su morbilidad y mortalidad. Objetivo: Describir el comportamiento clínico de E. coli extraintestinal en hospitales cubanos, así como determinar la resistencia antimicrobiana y la producción de betalactamasas. Métodos: Se realizó un estudio descriptivo de corte transversal, durante el período de mayo 2017 a junio 2018, en el Laboratorio Nacional de Referencia de Microbiología del Instituto de Medicina Tropical Pedro Kourí que incluyó 119 aislados de Escherichia coli causantes de infecciones extraintestinales en 30 hospitales de diferentes áreas geográficas del país. Se llevó a cabo la identificación mediante el sistema API 20E y la determinación de la susceptibilidad in vitro a 16 antimicrobianos por el sistema automatizado VITEK-2 y el método de difusión por disco, excepto para la colistina que se empleó el método de elución de disco. Se realizó, además, la detección fenotípica de betalactamasa de espectro extendido, de tipo AmpC y metalobetalactamasa. Resultados: E. coli extraintestinal causó con mayor frecuencia infección de herida quirúrgica (23,5 por ciento), infección del torrente sanguíneo (20,7 por ciento), infecciones respiratorias (17,6 por ciento), infecciones de piel (16,8 por ciento) e infección del tracto urinario (12,6 por ciento). Predominó la resistencia a betalactámicos que osciló entre 61,3 por ciento y 89,1 por ciento, mientras que 79,8 por ciento y 80,5 por ciento de los aislados fueron resistentes a trimetoprim/sulfametoxazol y tetraciclina, respectivamente. La amikacina, la fosfomicina, la colistina y los carbapenémicos mostraron mayor actividad in vitro. El 43,7 por ciento produjo betalactamasas de espectro extendido, 7,6 por ciento AmpC plasmídica y 0,8 por ciento metalobetalactamasa. Conclusiones: La escasa sensibilidad en los aislados de E. coli extraintestinal a los antimicrobianos de primera línea, así como la detección de un aislado productor de metalobetalactamasa evidencia la necesidad de mantener un monitoreo continuo de este patógeno para el cual las alternativas de tratamiento son cada vez más restringidas(AU)


Introduction: Extraintestinal Escherichia coli is one of the main pathogens causing infections associated to health care, with a high impact on health, due to its morbidity and mortality. Objective: Describe the clinical behavior of extraintestinal E. coli in Cuban hospitals, and determine antimicrobial resistance and betalactamase production. Methods: A descriptive cross-sectional study was conducted at the Microbiology National Reference Laboratory of Pedro Kourí Tropical Medicine Institute from May 2017 to June 2018. The study included 119 Escherichia coli isolates causing extraintestinal infections in 30 hospitals from various geographic areas in the country. Identification was based on the API 20E system, and determination of in vitro susceptibility to 16 antimicrobials on the automated system VITEK-2 and the disk diffusion method, except for colistin, for which the disk elution method was used. Phenotypical detection was also performed of AmpC extended-spectrum betalactamase and metallobetalactamase. Results: The most common disorders caused by extraintestinal E. coli were surgical wound infection (23.5 percent), bloodstream infection (20.7 percent), respiratory infections (17.6 percent), skin infections (16.8 percent) and urinary tract infection (12.6 percent). A predominance was found of resistance to betalactams, which ranged between 61.3 percent y 89.1 percent, whereas 79.8 percent and 80.5 percent of the isolates were resistant to trimethoprim / sulfamethoxazole and tetracycline, respectively. Amikacin, fosfomycin, colistin and carbapenemics displayed greater in vitro activity. 43.7 percent produced extended spectrum betalactamases, 7.6 percent plasmid AmpC and 0.8 percent metallobetalactamase. Conclusions: The low sensitivity of extraintestinal E. coli isolates to first-line antimicrobials and the detection of a metallobetalactamase producing isolate are evidence of the need to maintain continuous surveillance of this pathogen, for which the treatment options are ever more restricted.


Subject(s)
Humans , beta-Lactam Resistance/drug effects , Anti-Infective Agents/therapeutic use , Epidemiology, Descriptive , Cross-Sectional Studies , Extraintestinal Pathogenic Escherichia coli/pathogenicity
7.
Washington; Organización Panamericana de la Salud; ago 25, 2020. 28 p.
Non-conventional in Spanish | LILACS | ID: biblio-1117908

ABSTRACT

En el transcurso de la pandemia de COVID-19, numerosos países, de ingresos bajos, medianos y alto, han visto agotadas sus reservas de medicamentos esenciales necesarios para el manejo de los pacientes con COVID-19 en las unidades de cuidados intensivos (UCI). El plan de preparación para emergencias sanitarias de los países requiere incluir una lista de medicamentos esenciales y otros dispositivos médicos necesarios en las UCI para afrontar emergencias sanitarias. La lista de medicamentos esenciales para el manejo de pacientes que ingresan a unidades de cuidados intensivos con sospecha o diagnóstico confirmado de COVID-19 es un documento de orientación fundamental que ayuda a los sistemas de salud de los países a priorizar los medicamentos esenciales que deben estar ampliamente disponibles y ser asequibles para manejar los pacientes en las UCI durante las situaciones de emergencia sanitaria, en este caso con sospecha o diagnóstico confirmado de COVID-19. Está dirigida a las autoridades sanitaras y a los encargados del manejo del sistema de salud de los países. Esta lista incluye fundamentalmente los medicamentos considerados esenciales para el manejo de los cuadros clínicos que con se observan con mayor frecuencia en pacientes hospitalizados en UCI a causa de una infección por SARS-CoV-2. No se incluyen la mayoría de los medicamentos que comúnmente se encuentran en las UCI para el manejo de otras patologías, comorbilidades o la estabilización del paciente (p. ej., insulina o antihipertensivos), salvo aquellos que pueden requerirse para el tratamiento o apoyo (p. ej., bloqueantes neuromusculares o anestésicos) de las dolencias generadas por la infección. Tampoco se incluyen medicamentos específicos para el tratamiento de la infección por SARS-CoV-2, puesto que no existe, por el momento, evidencia científica de alta calidad que avale su uso, salvo en el contexto de ensayos clínicos controlados. Un equipo de expertos en el tema realizó una búsqueda de información sobre la atención de pacientes en UCI durante la pandemia de COVID-19, en Medline (a través de PubMed), Cochrane, Tripdatabase, Epistemonikos y en buscadores generales de internet (Google). Se identificaron también revisiones o guías generadas por ministerios de Salud de varios países de la Región de las Américas, la Organización Mundial de la Salud (OMS), la Organización Panamericana de la Salud (OPS), el Instituto Nacional de Salud y Excelencia Clínica (NICE) de Reino Unido, los Centros para el Control y la Prevención de Enfermedades (CDC) de Estados Unidos y los Institutos Nacionales de Salud (NIH) de Estados Unidos.


Subject(s)
Humans , Child , Adult , Pneumonia, Viral/drug therapy , Succinylcholine/therapeutic use , Antipsychotic Agents/therapeutic use , Benzodiazepines/therapeutic use , Patient Care Management/organization & administration , Dexamethasone/therapeutic use , Adrenal Cortex Hormones/therapeutic use , Coronavirus Infections/drug therapy , Drugs, Essential/supply & distribution , Dexmedetomidine/therapeutic use , Severe Acute Respiratory Syndrome/drug therapy , Antipyretics/therapeutic use , Pandemics/prevention & control , Betacoronavirus/drug effects , Haloperidol/therapeutic use , Analgesics, Opioid/therapeutic use , Intensive Care Units/organization & administration , Anti-Infective Agents/therapeutic use , Pneumonia, Viral/prevention & control , Respiration, Artificial/nursing , Shock, Septic/prevention & control , Thromboembolism/prevention & control , Coronavirus Infections/prevention & control , Evidence-Based Medicine , Intubation/nursing , Hypoxia/drug therapy
8.
Rev. epidemiol. controle infecç ; 10(2): 151-157, abr.-jun. 2020. ilus
Article in Portuguese | LILACS | ID: biblio-1223692

ABSTRACT

Justificativa e objetivos. Programas de gestão de antimicrobianos (PGA) podem contribuir para otimizar o uso de antimicrobianos em unidades de tratamento intensivo neonatais (UTINEO). O objetivo deste estudo foi mensurar o consumo de antimicrobianos, dentre eles os carbapenêmicos e infecções relacionadas à assistência à saúde (IRAS), especificamente as causadas por bactérias Gram-negativas resistentes a carbapenêmicos (BGN-CR) em neonatos após a implantação de um PGA. Métodos: Estudo prospectivo descritivo do consumo de antimicrobianos, dentre eles os carbapenêmicos; e das taxas de IRAS em uma UTINEO, durante 1 ano de seguimento. O consumo fo i medido em dias de terapia/1000 pacientes-dia (DOT/1000PD). Resultados: Em setembro de 2017 o PGA foi implementado com os seguintes elementos-chave: auditoria de antibióticos/feedback, restrição de antimicrobianos-alvo, medida do consumo de antimicrobianos e maior rapidez na liberação de resultados de culturas. Entre setembro de 2017 e setembro de 2018 admitimos 308 pacientes, totalizando 2223 pacientes-dia. A mediana de consumo total de antimicrobianos foi de 1580 DOT/1000PD (variação de 1180,7 a 2336,6/mês) sem tendência de aumento e a de carbapenêmicos 12 DOT/1000PD (variação de 0 a 163,2/mês). O consumo de carbapenêmicos foi reduzido entre abril a setembro de 2018 (valor de p =0,07) quando comparado com os primeiros seis meses. Oito IRAS foram registradas, correspondendo a uma densidade de incidência de 3,6/1000 pacientes-dia. Não foram reportadas BGN-CR causando IRAS. Conclusões: O consumo total de antimicrobianos não apresentou aumento ao longo do ano após implantação do PGA. No entanto, houve redução significativa do consumo de carbapenêmicos. Não foram verificadas IRAS por BGN-CR no período do estudo.(AU)


Background and objectives: Antimicrobial stewardship programs (ASPs) could contribute to optimize antimicrobial use within neonatal intensive care units (NICUs). The aim of this study was to measure the antimicrobial consumption, including carbapenems and healthcare-associated infections (HAI), specifically infections caused by carbapenem-resistant Gram-negative bacteria (CR-GNB) in neonates, after implementation of an ASP. Methods: A prospective descriptive study of antimicrobial and carbapenem consumption; and healthcare-associated rate in a NICU, during a one-year follow-up. The consumption was measured in days of therapy /1000 patients-days(DOT/1000PD). Results: In September 2017, the ASP was implemented, with the following core components: antibiotic audit and feedback, restriction of target antimicrobials, measure of antimicrobial consumption and improvement of results from microbiologic laboratory. Between September 2017 and September 2018, we admitted 308 patients, totalizing 2223 patient-days. The median of total antimicrobial consumption was 1580 DOT/1000PD (range from 1180.7 to 2336.6/month and of carbapenems 12 DOT/1000PD (range from 0 to 162.3/month). The carbapenem consumption was reduced between April and September of 2018 (p value=0.07) when we compared the first six months of the study. Eight HAI were detected, corresponding to density of incidence of 3.6/1000 patient-days. No HAI due to CR-GNB was reported. Conclusion: The total antimicrobial consumption did not increase during all the year after the ASP implantation. Although there was a significant reduction of carbapenem consumption. Carbapenem-resistant bacteria was not found in NICU causing HAI.(AU)


Justificación y objetivos: Los programas de optimizatión de uso de antimicrobianos (POA) podrían contribuir a optimizar el uso de antimicrobianos dentro de las unidades de cuidados intensivos neonatales (UCIN). El objetivo de este estudio fue medir el consumo de antimicrobianos incluidos los carbapenems y las infecciones asociadas a la atención de la salud (IAAs), especificamente las infecciones causadas por bacterias Gram negativas resistentes a carbapenems (CR-GNB) en neonatos, después de la implementación de un POA. Métodos: Un estudio descriptivo prospectivo del consumo de antimicrobianos y carbapenems; y la tasa de IAAs en una UCIN durante un año de seguimiento. El consumo se midió en días de terapia (DOT) / 1000 pacientes-días. Resultados: En septiembre de 2017, se implementó el POA con los siguientes componentes principales: auditoría y retroalimentación de antibióticos, restricción de antimicrobianos objetivo, medición del consumo de antimicrobianos y mejora de los resultados del laboratorio microbiológico. Entre septiembre de 2017 y septiembre de 2018, admitimos 308 pacientes, totalizando 2223 días-paciente. La mediana del consumo total de antimicrobianos fue de 1580 DOT / 1000PD (rango de 1180.7 a 2336.6 / mes y de carbapenems 12 (rango de 0 a 162.3 / mes). El consumo de carbapenem se redujo entre abril y septiembre de 2018 (valor p = 0.07) cuando comparamos los primeros seis meses del estudio, se detectaron ocho IAAs, lo que corresponde a la densidad de incidencia de 3.6 / 1000 días-paciente No se informó ningún IAA debido a CR-GNB. Conclusiones: El consumo total de antimicrobianos no aumentó durante todo el año posterior a la implantación de POA. Aunque hubo una reducción significativa del consumo de carbapenem. No se encontraron bacterias resistentes a carbapenem en la UCIN que causa IAA.(AU)


Subject(s)
Humans , Infant, Newborn , Health Programs and Plans , Intensive Care Units, Neonatal , Cross Infection/microbiology , Delivery of Health Care , Antimicrobial Stewardship , Anti-Infective Agents/therapeutic use , Time Factors , Birth Weight , Carbapenems/therapeutic use , Prospective Studies , Gram-Negative Bacterial Infections/microbiology , Anti-Bacterial Agents/therapeutic use
9.
Arq. bras. med. vet. zootec. (Online) ; 72(1): 49-55, Jan.-Feb. 2020. tab, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1088911

ABSTRACT

The efficacy of an antisepsis protocol comprising chlorhexidine gluconate and ethyl alcohol in combination with prophylactic antimicrobial therapy in controlling surgical site infection in horses was studied. To that purpose, seven mixed breed horses received potassium penicillin and gentamicin at least 30 minutes prior to surgery. The surgical site was scrubbed with chlorhexidine gluconate and rinsed with ethyl alcohol. Samples were collected at four time points: (A) - before and (B) - immediately following shaving of the hair coat, (C) - at the end of antisepsis procedures, and (D) - at the end of the surgical procedure. Duration of surgery was recorded. Samples were cultured in three different culture mediums: Mitis Salivarus (Streptococcus sp.), Staphylococcus 110 (Staphylococcus sp.), and Mac Conkey (Enterobacteria). A high level of bacterial growth was observed in all culture mediums at (A) and (B), with no bacterial growth in (C). Staphylococcus sp. growth was observed in (D) in a single patient whose surgical procedure lasted for 120 minutes. Shaving of the hair coat reduced microbial flora on the surface of the skin. Antisepsis in combination with prophylactic antimicrobial therapy was effective in controlling surgical site infection in elective procedures with an average duration of 90 minutes.(AU)


Objetivou-se averiguar a eficácia do protocolo de antissepsia com clorexidina degermante e álcool etílico hidratado 70%, em associação com terapia antimicrobiana profilática, no controle microbiano do foco cirúrgico de equinos submetidos a procedimentos cirúrgicos. Foram utilizados 07 cavalos adultos de raças variadas, onde ambos receberam o mesmo tratamento (terapia antimicrobiana profilática e antissepsia com clorexidina degermante 2% e álcool etílico hidratado 70%), coletando-se amostras em quatro tempos distintos [(A - antes da tricotomia), (B - imediatamente após tricotomia), (C - ao término da antissepsia), (D - ao término do procedimento cirúrgico)]. O tempo de cada procedimento cirúrgico foi contabilizado. Foram utilizados três meios de cultura diferentes, cada um com especificidade para um tipo de crescimento bacteriano. Constatou-se alta incidência de crescimento bacteriano nos três meios utilizados nos tempos de coleta A e B. Para o tempo C, não foi observado crescimento bacteriano. No tempo D averiguou-se crescimento bacteriano do tipo Staphylococcus sp. em um único paciente, cujo tempo cirúrgico foi de 120 minutos de duração. Desta forma, a tricotomia reduziu a carga microbiana na superfície da pele. A antissepsia associada à terapia antimicrobiana profilática mostrou-se eficaz no controle microbiano do foco cirúrgico em procedimentos eletivos, com duração média de 90 minutos.(AU)


Subject(s)
Animals , Penicillins , Staphylococcus , Chlorhexidine , Antisepsis , Horses/surgery , Anti-Infective Agents/therapeutic use , Surgical Procedures, Operative/veterinary
10.
Pesqui. vet. bras ; 40(1): 17-28, Jan. 2020. tab, graf
Article in English | LILACS, VETINDEX | ID: biblio-1091657

ABSTRACT

The early use of antimicrobial therapy has been introduced in many farms to prevent diarrhea and respiratory disease in young calves; however, there is controversy about whether this practice has a beneficial effect on the health of these animals. This study evaluated the influence of the early use of antimicrobials on the health and performance of neonatal Holstein calves. Twenty-six Holstein calves were screened and divided into two groups, according to the administration (ATB+), or not (ATB-) of tulathromycin (2.5mg/kg, subcutaneously) within the first 12 hours of life. Calves were evaluated by general clinical examination, fecal score, respiratory score, and external palpation of the umbilical region, besides fecal output of dry matter. Anemia was determined by using an automatic system and, also, using a commercial kit for iron dosage. Diarrhea was diagnosed by a centrifuge-flotation technique using a sugar solution (Cryptosporidium) and multiplex semi-nested RT-PCR (rotavirus/coronavirus). The performance of the calves was estimated by Daily Weight Gain (DWG). The young dairy calves were evaluated within 12 hours of birth (≤12h) and at 3-5th (D3-5), 7-9th (D7-9), 13-15th (D13-15), 20-23rd (D20-23), and 27-30th (D27-30) days of life. No difference was noted between the ATB+ and ATB- groups concerning heart rate, respiratory frequency, and rectal temperature. Erythrogram showed a higher frequency of anemia in ATB- group (P=0.016) at the D3-5 check-up; lower values of serum iron were also observed simultaneously (P=0.051). Thirteen cases of respiratory disease were detected during this study; however, no significant difference was observed between the groups in this regard. The frequency of diarrhea (fecal score 2-3) was high in both groups, peaking at D13-D15. No differences were noted between the groups regarding the frequency of diarrhea when considering the dry fecal matter. The predominant etiological agent for diarrhea was Cryptosporidium spp.. The DWG was similar between groups, with maximum weight reduction on D13-15. The administration of tulathromycin in prophylactic dose (2.5mg/kg) at birth decreased the frequency of anemia but did not influence weight gain or the prevalence of diarrhea.(AU)


O uso precoce de antimicrobianos tem sido adotado em muitas fazendas para profilaxia das diarreias e doença respiratória em bezerras, no entanto existem controvérsias sobre os beneficios desta prática na saúde desses animais. Esta pesquisa avaliou a influência do uso precoce de antimicrobiano na sanidade e desempenho de bezerras holandesas recém-nascidas. Para tanto foram selecionadas 26 bezerras Holandesas distribuídas de acordo com a aplicação (ATB+) ou não (ATB-) de tulatromicina (2,5mg/Kg) por via subcutânea até 12h de vida. As bezerras foram examinadas por meio de exame clínico geral, escore fecal, escore respiratório e palpação externa da região umbilical, além da matéria seca fecal. A presença de anemias foi determinada pelo eritrograma utilizando sistema automático e além da dosagem de ferro utilizando kit comercial. O diagnóstico etiológico das diarreias foi investigado por meio da técnica de flutuação em solução saturada de sacarose (Cryptosporidium) e multiplex semi-nested RT-PCR (rotavírus/coronavírus). O desempenho das bezerras foi estimado pelo ganho de peso. As bezerras foram avaliadas até doze horas após o nascimento (≤12h); 3-5º (D3-5); 7-9º (D7-9); 13-15º (D13-15); 20-23º (D20-23); e 27-30º dias de vida (D27-30). Não foram encontradas diferenças entre os grupos ATB+ e ATB- em relação à frequência cardíaca, frequência respiratória e temperatura retal. O eritrograma revelou maior frequência de anemias no grupo ATB- (P=0,016) no D3-5. Neste momento também foram observados menores valores de ferro sérico (P=0,051). Foram detectados treze casos de doença respiratória durante o estudo, no entanto não foi possível detectar diferença entre os grupos. A frequência de diarreias (escore fecal 2 e 3) foi alta em ambos os grupos, observando-se pico no D13-15 (ATB+=92,3%; ATB-=92,3%). Não observamos diferenças entre os grupos em relação a frequência de diarreia considerando-se a matéria seca fecal. O agente etiológico predominante nas diarreias foi o Cryptosporidium. O ganho de peso diário foi igual entre grupos, com intensa redução no GPD no D13-15. A administração de tulatromicina na dose profilática (2,5mg/Kg) ao nascimento diminuiu a frequência de anemias e não influenciou no ganho de peso e prevalência de diarreias.(AU)


Subject(s)
Animals , Female , Cattle , Rotavirus Infections/veterinary , Macrolides/therapeutic use , Dysentery/etiology , Gastrointestinal Diseases/etiology , Anemia/prevention & control , Anti-Infective Agents/therapeutic use , Coronavirus, Bovine , Coronavirus Infections/veterinary , Cryptosporidiosis
11.
Rev. méd. Urug ; 36(3): 267-275, 2020. tab, graf
Article in Spanish | LILACS, BNUY | ID: biblio-1127106

ABSTRACT

Resumen: Introducción: un porcentaje de las infecciones del sistema nervioso central permanece sin diagnóstico etiológico. Las técnicas de amplificación de ácidos nucleicos mediante reacción en cadena de la polimerasa en tiempo real pueden disminuir este porcentaje. Objetivo: describir la etiología de las neuroinfecciones y valorar la utilidad de las técnicas de biología molecular en el diagnóstico y su impacto en el tratamiento antimicrobiano. Metodología: estudio observacional, descriptivo, retrospectivo a partir de registros clínicos. Se incluyeron mayores de 18 años asistidos en un hospital público de Montevideo durante un período de 32 meses, a quienes que se les realizaron técnicas de biología molecular en líquido cefalorraquídeo por sospecha clínica de neuroinfección. Resultados: se incluyeron 109 pacientes. En pacientes sin infección por VIH ni antecedentes neuroquirúrgicos (67%), se identificó microorganismo responsable en 16 casos, 8 bacterias y 9 virus. Todos identificados por técnicas de biología molecular modificando el tratamiento antimicrobiano empírico en 25 casos (34,2%). En portadores de VIH (25,7%), se detectaron microorganismos en 14 pacientes (50%). Seis virus, 5 bacterias y 7 hongos (Cryptococcus neoformans). El estudio por técnicas de biología molecular determinó el diagnóstico de 17 microorganismos y modificó el plan antimicrobiano inicial en 12 casos (42,9%). En pacientes con antecedente de neurocirugía reciente (7,3%), se aislaron seis microorganismos, tres de ellos exclusivamente mediante cultivo. Se modificó el tratamiento en tres casos (37,5%). Conclusiones: las técnicas de biología molecular deben considerarse complementarias. El impacto que generan en el diagnóstico y tratamiento justifica el uso de estas técnicas a pesar de su mayor costo.


Summary: Introduction: a certain percentage of infections of the central nervous system have no etiological diagnosis. Nucleic acids amplification techniques by means of a polymerase chain reaction in real time may reduce this percentage. Objective: to describe etiology of neuroinfectious diseases and assess the usefulness of molecular biology techniques in their diagnosis, as well as its impact on antimicrobial treatment. Method: observational, descriptive, retrospective study based on clinical records which included patients older than 18 years old, who had been assisted in a public hospital in Montevideo for over 32 months and had undergone molecular biology techniques with cerebrospinal fluid (CSF) given the clinical suspicion of neuroinfection. Results: 109 patients were included in the study. Among non-HIV infected patients who had not undergone neurosurgeries the responsible microorganism was identified in 16 cases (8 bacteria and 9 virus). They were all identified by molecular biology techniques by modifying the empiric antimicrobial therapy in 25 cases (34.2%). In carriers of HIV (25.7%), microorganisms were identified in 14 patients (50%). Six virus, 5 bacteria and 7 fungi (Cryptococcus neoformans). Molecular biology techniques defined the diagnosis of 17 microorganisms and modified the initial antimicrobial plan in 12 cases (42.9%). In patients with a history of recent neurosurgery (7.3%), 6 microorganisms were isolated, 3 of them exclusively through cultures. Treatment was modified in 3 cases (37.5%). Conclusions: molecular biology techniques need to be regarded as a complement. The impact that have in diagnosis and therapy justify their use despite its higher cost.


Resumo: Introdução: uma proporção das infecções do sistema nervoso central permanece sem diagnóstico etiológico. As técnicas de ampliação de ácidos nucléicos por reação em cadeia da polimerase em tempo real, podem diminuir esta proporção. Objetivo: descrever a etiologia das neuro infecções e avaliar a utilidade das técnicas de biologia molecular no diagnóstico e seu impacto no tratamento antimicrobiano. Metodologia: estudo observacional, descritivo, retrospectivo de prontuários de pacientes. Foram incluídos pacientes maiores de 18 anos, atendidos em um hospital público de Montevidéu, durante um período de 32 meses. Foram realizadas técnicas de biologia molecular ao líquido cefalorraquidiano por suspeita clínica de neuroinfecção. Resultados: foram incluídos 109 pacientes. Em pacientes sem infecção por VIH e sem antecedentes neurocirúrgicos (67%), o microrganismo responsável em 16 casos, sendo 8 bactérias e 9 vírus. Todos foram identificados por técnicas de biologia molecular modificando el tratamento antimicrobiano empírico em 25 casos (34,2%). Em portadores de VIH (25,7%), foram detectados microrganismos em 14 pacientes (50%). Seis vírus, 5 bactérias e 7 leveduras (Cryptococcus neoformans). O estudo por técnicas de biologia molecular permitiu o diagnóstico de 17 microrganismos e modificou o tratamento antimicrobiano inicial em 12 casos (42,9%). Em pacientes com antecedentes de neurocirurgia recente (7,3%), foram isolados 6 microrganismos, em 3 casos exclusivamente por cultura. O tratamento foi modificado em 3 casos (37,5%). Conclusões: as técnicas de biologia molecular devem ser consideradas como complementares. O impacto que causam sobre o diagnóstico e o tratamento justifica seu uso apesar de seu maior custo.


Subject(s)
Humans , Central Nervous System Infections/diagnosis , Central Nervous System Infections/etiology , Molecular Biology/methods , Anti-Infective Agents/therapeutic use
12.
Rev. cuba. estomatol ; 56(4): e1159, oct.-dez. 2019. tab
Article in Portuguese | LILACS | ID: biblio-1093246

ABSTRACT

RESUMO Introdução: No Brasil, uma lista contendo 71 ervas medicinais foi divulgada pelo Ministério da Saúde com intuito de conduzir pesquisas e desenvolvimento de fitoterápicos para uso no Sistema Único de Saúde. Objetivo: Avaliar in vitro a atividade antimicrobiana de extratos de ervas medicinais sugeridos pelo Ministério da Saúde para utilização no Sistema Único de Saúde frente a bactérias orais. Métodos: Os extratos vegetais selecionados estavam na forma de óleo essencial (Eucalyptus globulus, Mentha piperita e Schinus terebinthifolius) ou tintura (Erythrina mulungu, Casearia sylvestris e Maytenus ilicifolia) e foram avaliados sobre Streptococcus mutans (ATCC 25175), S. oralis (ATCC 10557) e S. salivarius (ATCC 7073). Realizou-se o teste de difusão em ágar com confecção de poços e adição de 50 µL dos extratos. Após 48 h em estufa bacteriológica, os halos de inibição foram medidos através de paquímetro. Para determinação da concentração inibitória mínima e da concentração bactericida mínima, realizou-se a técnica de microdiluição em microplacas e de esgotamento, respectivamente. A concentração inibitória mínima correspondeu a menor diluição na qual se verificou ausência de crescimento bacteriano visível. O controle positivo utilizado foi Clorexidina 0,12 porcento. Todos os testes foram realizados em triplicata e analisados descritivamente. Resultados: O extrato de Maytenus ilicifolia apresentou halos de inibição discretamente maiores aos demais produtos. Erythrina mulungu apresentou a menor da concentração inibitória mínima frente S. mutans (2,81 mg/mL) entre as tinturas e Mentha piperita (9,00), entre os óleos essenciais. Erythrina mulungu e Mentha piperita foram os únicos extratos que apresentaram concentração bactericida mínima frente às cepas utilizadas. Conclusão: Os extratos vegetais apresentaram atividade antimicrobiana frente a microrganismos orais destacando Mentha piperita e Erythrina mulungu(AU)


RESUMEN Introducción: En Brasil, una lista de 71 hierbas medicinales fue divulgada por el Ministerio de Salud con la meta de llevar a cabo la investigación y desarrollo de medicinas basadas en hierbas para su uso en el Sistema Único de Salud. Objetivo: Evaluar la actividad antimicrobiana in vitro de extractos de hierbas medicinales sugeridas por el Ministerio de Salud para su uso en el Sistema Único de Salud contra las bacterias bucales. Métodos: Los extractos de plantas seleccionadas fueron en forma de aceite essencial (Eucalyptus globulus, Mentha piperita e Schinus terebinthifolius) o tintura (Erythrina mulungu, Casearia sylvestris e Maytenus ilicifolia) y se evaluaron en Streptococcus mutans (ATCC 25175), S. oralis (ATCC 10557) y S. salivarius (ATCC 7073). Se llevó a cabo la prueba de difusión en agar con la producción de los pozos y la adición de 50 µL de extractos. Después de 48 h en una incubadora bacteriológica, los halos de inhibición se midieron usando calibradores. Para determinar la concentración inhibitoria mínima y la concentración bactericida mínima, se empleó la técnica de microdilución en microplaca y el agotamiento, respectivamente. La concentración inhibitoria mínima correspondió a la dilución más baja en la que no hubo ningún crecimiento bacteriano visible. El control positivo usado fue de clorhexidina 0,12 por ciento. Todas las pruebas se realizaron por triplicado y se analizaron de manera descriptiva. Resultados: Los extractos de Maytenus ilicifolia presentaron los halos de inhibición ligeramente superior a otros productos. Erythrina mulungu mostró la más baja concentración inhibitoria mínima frente a S. mutans (2,81 mg/mL) entre lãs tinturas y Mentha piperita (9,00) entre los aceites esenciales. Los extractos de Erythrina y Mentha piperita fueron los únicos que mostraron concentración bactericida mínima frente a las cepas utilizadas. Conclusiones: Los extractos de plantas mostraron actividad antimicrobiana contra microorganismos bucales, entre los que se destacan Mentha piperita y Erythrina mulungu(AU)


ABSTRACT Introduction: A list of 71 medicinal herbs has been published by the Brazilian Ministry of Health with the purpose of studying and developing medicines obtained from herbs for their potential use in the Unified Health System. Objective: Evaluate the in vitro antimicrobial activity of extracts from medicinal herbs proposed by the Ministry of Health with a view to their possible use in the Unified Health System to combat oral bacteria. Methods: Extracts were obtained from the plants selected in the form of essential oil (Eucalyptus globulus, Mentha piperita and Schinus terebinthifolius) or tincture (Erythrina mulungu, Casearia sylvestris and Maytenus ilicifolia), and were tested against Streptococcus mutans (ATCC 25175), S. oralis (ATCC 10557) and S. salivarius (ATCC 7073). The agar diffusion test was performed by making wells and adding 50 µL of the extracts. After 48 h in a bacteriological incubator, the inhibition haloes were measured with calipers. Minimum inhibitory concentration and minimum bactericidal concentration were determined by microplate microdilution and depletion technique, respectively. The minimum inhibitory concentration corresponded to the lowest dilution, at which there was no visible bacterial growth. The positive control used was 0.12 percent chlorhexidine. All the tests were performed in triplicate and analyzed descriptively. Results: Maytenus ilicifolia extracts exhibited slightly higher inhibition haloes than the other products. Erythrina mulungu had the lowest minimum inhibitory concentration against S. mutans (2.81 mg/mL) among tinctures, and Mentha piperita (9.00) among essential oils. Erythrina and Mentha piperita extracts were the only two displaying minimum bactericidal concentration against the strains used. Conclusions: The study plant extracts displayed antimicrobial activity against oral microorganisms, particularly against Mentha piperita and Erythrina mulungu(AU)


Subject(s)
Humans , Plants, Medicinal/adverse effects , Anti-Infective Agents/therapeutic use , Mouth/microbiology
14.
Prensa méd. argent ; 105(5): 302-308, jun 2019. fig, tab
Article in English | LILACS, BINACIS | ID: biblio-1024638

ABSTRACT

Aim: The current venture, were made to evaluate the inhibitory effect of Trigonella foenum seed Extract and ZiO2 Nanoparticles on some selected species of Fungi and Bacteria. Materials and Methods: two bacterial species included Pseudomonas aeruginosa and Staphylococcus aureus and three fungal species which is Cryptococcus neoformans, Candidda albicans and Chaetomium were used to evaluate the antibacterial activity of Trigonella foenum Extract and ZiO2 Nanoparticles. Results: This study showed that the Zirconium Oxide (ZiO2) nanoparticles have antifungal and antibacterial activities on the isolates of Cryptococcus neoformans, Candida alicans and Staphylococcus aureus, respectively. While the antimicrobial activity of Zirconium Oxide nanoparticles on the Chaetomium and Pseudomonas aeruginosa was negative. All tested fungi and bacterial isolates were found to be sensitive to Trigonella foenum seed extract, the results of the compination of the ZiO2 Nanoparticle and the Trigonella foenum seed extract were poisitive for all tested fungi isolates and bacterial isolates. The XRD analysis was done for Zirconium Oxide nanoparticles and the result showed that the biocrystallization on the surface of the Zirconium Oxide manoparticles. The average partides size was about (29.8) nm. Conclusions: This investigation conclude that the use of Trigonella foenum seed Extract has the effect of killing all bacteria and fungi under study, result indicate the Trigonella foenun seed Extract best antibacterial efficacy than the ZiO2 together (AU)


Subject(s)
Humans , Pseudomonas aeruginosa/pathogenicity , Staphylococcus aureus/pathogenicity , Candida albicans/pathogenicity , Chaetomium/pathogenicity , Cryptococcus neoformans/pathogenicity , Trigonella/microbiology , Nanoparticles/adverse effects , Fabaceae/adverse effects , Anti-Infective Agents/therapeutic use , Anti-Bacterial Agents/therapeutic use , Antifungal Agents/therapeutic use
15.
An. bras. dermatol ; 94(2,supl.1): 67-75, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1011092

ABSTRACT

Abstract: BACKGROUND: Atopic dermatitis is a highly prevalent inflammatory and pruritic dermatosis with a multifactorial etiology, which includes skin barrier defects, immune dysfunction, and microbiome alterations. Atopic dermatitis is mediated by genetic, environmental, and psychological factors and requires therapeutic management that covers all the aspects of its complex pathogenesis. OBJECTIVES: The aim of this article is to present the experience, opinions, and recommendations of Brazilian dermatology experts regarding the therapeutic management of atopic dermatitis. METHODS: Eighteen experts from 10 university hospitals with experience in atopic dermatitis were appointed by the Brazilian Society of Dermatology to organize a consensus on the therapeutic management of atopic dermatitis. The 18 experts answered an online questionnaire with 14 questions related to the treatment of atopic dermatitis. Afterwards, they analyzed the recent international guidelines on atopic dermatitis of the American Academy of Dermatology, published in 2014, and of the European Academy of Dermatology and Venereology, published in 2018. Consensus was defined as approval by at least 70% of the panel. RESULTS/CONCLUSION: The experts stated that the therapeutic management of atopic dermatitis is based on skin hydration, topical anti-inflammatory agents, avoidance of triggering factors, and educational programs. Systemic therapy, based on immunosuppressive agents, is only indicated for severe refractory disease and after failure of topical therapy. Early detection and treatment of secondary bacterial and viral infections is mandatory, and hospitalization may be needed to control atopic dermatitis flares. Novel target-oriented drugs such as immunobiologicals are invaluable therapeutic agents for atopic dermatitis.


Subject(s)
Humans , Consensus , Dermatitis, Atopic/drug therapy , Societies, Medical , Ultraviolet Therapy , Severity of Illness Index , Brazil , Administration, Topical , Adrenal Cortex Hormones/therapeutic use , Dermatology , Calcineurin Inhibitors/therapeutic use , Anti-Infective Agents/therapeutic use , Anti-Inflammatory Agents/therapeutic use
16.
Rev. cuba. salud pública ; 45(1)ene.-mar. 2019. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-991122

ABSTRACT

Introducción: El uso irracional de antimicrobianos es un problema de salud. En el Cardiocentro Pediátrico William Soler existe una amplia utilización de ellos, sin embargo, no se conoce el comportamiento del consumo de este grupo farmacológico en la institución. Objetivo: Describir el consumo de antimicrobianos seleccionados en la institución en el periodo 2011-2015. Método: Estudio descriptivo, longitudinal del tipo estudio de utilización de medicamentos de consumo de 11 antimicrobianos, de uso restringido y elevado costo (cefepime, meropenem, levofloxacina oral y parenteral, linezolida, teicoplanina, vancomicina, colistina, aztreonam y amoxicilina/sulbactam oral y parenteral). El consumo en unidades físicas se obtuvo a partir de las tarjetas de estiba del almacén de medicamentos de la farmacia intrahospitalaria. Para el cálculo se utilizó la fórmula establecida por la Organización Mundial de la Salud, expresado en dosis diaria definida/100 camas/día (DDD/100 camas/día). Resultados: Se observó un incremento de 7,28 DDD/100 camas/día, los años 2013 y 2015 se mostraron como los de mayor consumo. Los fármacos más consumidos fueron el meropenem con un incremento de 2,71 DDD/100 camas/día; el cefepime con un incremento de 1,68 DDD/100 camas/día y la linezolida con un aumento de 1,15 DDD/100 camas/día. La terapia 1 y la sala 1A mostraron los mayores valores de consumo. Conclusiones: Los antimicrobianos han reducido de manera importante la amenaza de enfermedades infecciosas y son una herramienta indispensable en el tratamiento de los pacientes en los hospitales. El consumo de antimicrobianos seleccionados en el Cardiocentro Pediátrico William Soler, considerados de alto costo y utilización restringida, evidencia una tendencia al incremento, lo cual muestra la necesidad de desarrollar un programa de optimización de uso de estos medicamentos en la institución(AU)


Introduction: The irrational use of antimicrobials is a health problem. In William Soler Pediatric Cardiocenter there is a wide use of them; however, the behavior of the consumption of this pharmacological group in the institution is not known. Objective: To describe the consumption of selected antimicrobials in the institution in the period 2011-2015. Method: Descriptive, longitudinal study of the use of medicines for the consumption of 11 antimicrobials, of restricted use and high cost (cefepime, meropenem, oral and parenteral levofloxacin, linezolid, teicoplanin, vancomycin, colistin, aztreonam and amoxicillin / oral and parenteral sulbactam). The average consumption in physical units was obtained from the stowage cards of the drug store of the in-hospital pharmacy. For the calculation, the formula established by the World Health Organization was used and this is expressed in a defined daily dose / 100 beds / day (DDD / 100 beds / day). Results: An increase of 7.28 DDD / 100 beds / day was observed; the years 2013 and 2015 were shown as those with the highest consumption. The most consumed drugs were meropenem with an increase of 2.71 DD / 100 beds / day; cefepime with an increase of 1.68 DD / 100 beds / day; and linezolid with an increase of 1.15 DDD / 100 beds / day. Therapy room 1 and room 1A showed the highest consumption values. Conclusions: Antimicrobials have reduced in a crucial way the threat that infectious diseases represent, and they are also an indispensable tool in the treatment of patients in hospitals. The consumption of selected antimicrobials considered of high cost and restricted use in William Soler Pediatric Cardiocenter shows a tendency to increase, which shows the need to develop a program to optimize the use of antimicrobials in the institution(AU)


Subject(s)
Humans , Child , Substance Abuse, Intravenous , Hospitals, Pediatric , Anti-Infective Agents/therapeutic use , Epidemiology, Descriptive , Longitudinal Studies , Cuba
17.
Arch. Health Sci. (Online) ; 25(3): 46-52, 21/12/2018.
Article in Portuguese | LILACS | ID: biblio-1046418

ABSTRACT

Introdução: Nos últimos anos ocorreu o aumento de casos relacionados com a infecção por Candida spp. e Staphylococcus spp., bem como o aparecimento de cepas resistentes a antibióticos convencionais. A biossíntese de nanopartículas consiste na redução de um íon metálico por compostos de origem natural como metabólitos secundários de plantas e organismos, sendo a forma mais indicada por apresentar menor toxicidade quando comparada à síntese química. Desta forma, a síntese biológica constitui uma alternativa para a obtenção de novos agentes ativos para o tratamento de infecções microbianas. Objetivos: Sintetizar nanopartículas de prata a partir do extrato aquoso de Mikania glomerata Sprengel e avaliar possível atividade microbicida e citotóxica. Material e Métodos: Para a síntese das nanopartículas de prata (AgNPs) foi utilizado um extrato aquoso das folhas de M. glomerata e uma solução de nitrato de prata. As AgNPs sintetizadas foram avaliadas por espectrofotômetro UV-vis e espectrometria de absorção atômica com chama. Além disso, a atividade antimicrobiana foi avaliada contra cepas de Candida albicans e Staphylococcus aureus e atividade citotóxica contra linhagens celulares HeLa e Vero. Resultados: As AgNPs são mais eficientes no combate à linhagem de Candida albicans e Staphylococcus aureus quando comparadas ao extrato puro administrado. Até a concentração de 100 mg/mL do extrato puro não foi observado efeito inibitório em ambos os micro-organismos. Entretanto quando em contato com as AgNPs, a concentração inibitória foi de 0,006 mg/mL e 0,1 mg/mL para S. aureus e C. albicans, respectivamente. O efeito citotóxico nas células se comportou de maneira dose-dependente, apresentando maior potencial citotóxico contra a linhagem celular cancerosa HeLa. Conclusão: As AgNPs sintetizadas apresentaram potencial antimicrobiano contra C. albicans e S. aureus, além de baixa atividade contra células normais, indicando sua confiabilidade para aplicação das AgNPs como forma alternativa de tratamento. Estes resultados são promissores e contribuem para pesquisa relacionada à produção de medicamentos utilizando extrato de plantas e metais.


Introduction: In recent years there has been an increase in cases related to infection by Candidaspp. and Staphylococcus spp., as well as the appearance of strains resistant to conventional antibiotics. Nanoparticle biosynthesis consists of the reduction of a metal ion by compounds of natural origin as secondary metabolites of plants and organisms, being the most indicated form because it presents less toxicity when compared to the chemical synthesis. In this way, the biological synthesis is an alternative to obtain new active agents for the treatment of microbial infections. Objective: Synthesize silver nanoparticles from the aqueous extract of Mikania glomerata Sprengel and evaluate possible microbicidal and cytotoxic activity. Material and Methods: For the synthesis of the silver nanoparticles (AgNPs) an aqueous extract of the leaves of Mikania glomerata plus a solution of silver nitrate was used. AgNPs synthesized was evaluated by UV-vis spectrophotometer and FAAS. Furthermore, antimicrobial activity was evaluated against strains of Candida albicans and Staphylococcus aureus and cytotoxicity activity against HeLa and Vero cell lines. Results: AgNPs are shown to be more efficient in combating Candida albicans and Staphylococcus aureusstrains when compared to the pure administered extract. Up to the concentration of 100 mg/mL of the pure aqueous extract no inhibitory effect was observed on both microorganisms. However when the strains were in contact with AgNPs, the inhibitory concentration was 0.006 mg/mL and 0.1 mg/mL for S. aureus and C. albicans, respectively. The cytotoxic effect on the cells behaves in a dose-dependent manner, presenting greater cytotoxic potential against the HeLa cancer cell line. Conclusion: Thus, these results are promising and contribute to research related to the production of drugs using plant extract and metals. The AgNPs synthesized presented the antimicrobial potential against C. albicans and S. aureus, in addition to low activity against normal cells, indicating their reliability for application of AgNPs as an alternative form of treatment.


Subject(s)
Staphylococcus aureus/drug effects , Candida albicans/drug effects , Metal Nanoparticles/therapeutic use , Anti-Infective Agents/therapeutic use
18.
Med. leg. Costa Rica ; 35(2): 62-70, sep.-dic. 2018.
Article in Spanish | LILACS | ID: biblio-954932

ABSTRACT

Resumen Sinusitis, definida como enfermedad inflamatoria de la mucosa de los senos paranasales, es una enfermedad con alta prevalencia e incidencia en la población general, especialmente en Pediatría.1 Los padecimientos alérgicos e infecciosos de la mucosa nasal representan dos de las enfermedades más frecuentes de las vías aéreas superioras crónicas en niños y adultos jóvenes. Es un problema de salud pública de gran magnitud debido a su alta prevalencia, lo que ocasiona gran presión asistencial en términos de consultas ambulatorias, deterioro significativo de la calidad de vida para el paciente y sus familiares además, implica un fuerte impacto en la comunidad por los altos costos socioeconómicos que generan.2 Su etiología multifactorial y la creciente resistencia bacteriana a antibióticos, especialmente a penicilinas naturales o sintéticas sugiere reconsiderar los fundamentos anatómicos y funcionales con la finalidad de establecer conductas razonables de diagnóstico, terapéutica médica y quirúrgica que permitan un diagnóstico y tratamiento apropiado para disminuir su recurrencia.1,2


Abstract Sinusitis, defined as an inflammatory disease of the paranasal sinuses, is a disease with high prevalence and incidence in the general population, especially among children. The allergic and infectious diseases of the nasal mucosa represent two of the most frequent diseases of the chronic upper airways in children and young adults. It is a public health problem of great magnitude due to its high prevalence, which causes great assistance pressure in terms of outpatient consultations, significant deterioration of the quality of life for the patient and their families, and it also implies a strong impact on the community due to the high socio-economic costs. Its multifactorial etiology and the increasing bacterial resistance to antibiotics, especially natural or synthetic penicillins, suggest reconsidering the anatomical and functional foundations in order to establish reasonable diagnostic, medical and surgical therapeutic behaviors that allow a diagnosis and appropriate treatment to decrease its recurrence.


Subject(s)
Humans , Child, Preschool , Child , Paranasal Sinuses , Pediatrics , Sinusitis/diagnosis , Sinusitis/etiology , Anti-Infective Agents/therapeutic use , Anti-Bacterial Agents/therapeutic use , Nasal Mucosa
19.
An. bras. dermatol ; 93(5): 730-732, Sept.-Oct. 2018. graf
Article in English | LILACS | ID: biblio-949940

ABSTRACT

Abstract: Neutrophilic dermatosis of the dorsal hands is considered a rare and localized variant of Sweet's syndrome. Although the etiology is unknown, there are reports of association with infections, neoplasias, autoimmune diseases and medications. Histopathology shows a dense neutrophilic inflammatory infiltrate in the dermis. Treatment is based on the administration of systemic corticosteroids; however, a combination of medications is useful, given the frequency of relapses. The authors report a classic and clinically exuberant case of neutrophilic dermatosis of the dorsal hands, with excellent response to oral dapsone treatment, and offer a brief literature review.


Subject(s)
Humans , Female , Middle Aged , Sweet Syndrome/drug therapy , Dapsone/therapeutic use , Hand Dermatoses/drug therapy , Anti-Infective Agents/therapeutic use , Sweet Syndrome/complications , Hand Dermatoses/etiology
20.
Braz. j. infect. dis ; 22(4): 328-337, July-Aug. 2018. tab, graf
Article in English | LILACS | ID: biblio-974219

ABSTRACT

ABSTRACT Background Technologies and life support management have enhanced the survival of preterm infants. The immune system of newborns is immature, which contributes to the occurrence of healthcare-associated infections. The overlap of several conditions with neonatal sepsis and the difficulty of diagnosis and laboratory confirmation during this period result in a tendency to over-treat neonatal sepsis. The use of antimicrobial agents is a risk factor for multidrug-resistant bacterial infections. This work aimed to perform a systematic review of the relationship between inadequate use of antimicrobial agents and increase in neonatal sepsis related to healthcare assistance, due to bacterial resistance. Methods Our population, exposition, comparison, outcome and study type was as follows: P: hospitalized neonates with sepsis diagnosis, E: inappropriate use of antimicrobial agents, C: adequate use of antimicrobial agents or no indication of infection, O: resistant bacterial infection, and S: original studies. We performed searches in the PubMed, Scopus, Virtual Health Library (Scielo, LILACS, and MEDLINE), and Embase without limits on time, language, and the references of the articles found. Fourteen studies were included and assessed using the Grading of Recommendations, Assessment, Development, and Evaluation, Newcastle, and the Strengthening the Reporting of Observacional Studies in Epidemiology methodologies. Results All studies found were observational and started with a low-quality evidence level in the Grading of Recommendations, Assessment, Development, and Evaluation. Conclusions Despite their low-quality evidence, the studies demonstrated the association between inadequate use of antimicrobial agents and increase of neonatal resistant bacterial healthcare-associated infections in neonatal units. However, there is significant difficulty in conducting high-quality studies in this population due to ethical issues tied to randomized trials. Therefore, new studies should be encouraged to recommend adequate treatment of newborns without increasing the risk of healthcare-associated infections by multidrug-resistant bacteria.


Subject(s)
Humans , Infant, Newborn , Cross Infection/drug therapy , Gram-Negative Bacterial Infections/drug therapy , Drug Resistance, Multiple, Bacterial , Neonatal Sepsis/drug therapy , Anti-Infective Agents/therapeutic use , Anti-Bacterial Agents/therapeutic use , Risk Factors , Gram-Negative Bacterial Infections/microbiology , Evidence-Based Medicine , Neonatal Sepsis/microbiology , Gram-Negative Bacteria/drug effects , Anti-Bacterial Agents/adverse effects
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