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1.
repert. med. cir ; 31(1): 63-70, 2022. tab.
Article in English, Spanish | LILACS, COLNAL | ID: biblio-1366995

ABSTRACT

Introducción: los enterococos son responsables de múltiples infecciones y por su creciente patrón de resistencia se ha vuelto de interés en el país y en el mundo. Objetivo: caracterizar las infecciones por Enterococcus spp. Metodología: estudio descriptivo, retrospectivo observacional transversal desde enero 2015 hasta enero 2018 en un hospital regional. Resultados: la prevalencia de las infecciones por Enterococcus spp. fue de 0,154%. El E. faecalis fue el más aislado, seguido del E. faecium. La resistencia a ampicilina fue de 19% y a vancomicina de 10%; 32% de los pacientes tuvieron terapia empírica con vancomicina y 22% con piperacilina tazobactam, la mediana de antibioticoterapia fue de 10 días. Discusión: el interés por los Enterococcus spp. se ha incrementado debido a que representan una carga importante en las infecciones asociadas con la atención en salud (IAAS). La mayoría se dan en hombres con una edad mediana de 40 a 60 años, hospitalizados en UCI, con infecciones urinarias y comorbilidades como inmunosupresión y cirugías previas. Conclusión: como ha venido reportándose aumento en las tasas de resistencia a vancomicina y ampicilina, se recomienda el uso responsable de la terapia antibiótica, con la finalidad de erradicar en forma eficaz al patógeno y prevenir nuevas resistencias.


Introduction: enterococci can cause multiple infections and due to their increasing resistance to antibiotics they have become of national and global concern. Objective: to characterize infections caused by Enterococcus spp.Methodology: descriptive, retrospective observational cross-sectional study conducted from January 2015 to January 2018 in a regional hospital. Results: the prevalence of Enterococcus spp. infections was 0.154%. E. faecalis was the most commonly isolated, followed by E. faecium. Antibiotic resistance was 19% and 10% for ampicillin and vancomycin respectively, 32% of patients received empirical therapy with vancomycin and 22% with piperacillin tazobactam. The median duration of antibiotic therapy was 10 days. Discussion: interest in Enterococcus spp. has increased for they are recognized as an important burden in healthcare-associated infections (HAIs). Enterococcal infection occurs mainly among men, median age 40 to 60 years, hospitalized in the ICU, with urinary tract infections and comorbidities such as immunosuppression and previous surgeries. Conclusion: as an increased rate of vancomycin and ampicillin resistance in enterococci has been reported, a responsible use of antibiotic therapy is recommended in order to effectively eradicate the pathogen and prevent the emergence of new bacterial resistances.


Subject(s)
Humans , Male , Female , Middle Aged , Drug Resistance, Microbial , Epidemiology , Enterococcus , Delivery of Health Care , Hospitals
2.
Braz. j. biol ; 81(4): 954-961, Oct.-Dec. 2021. tab, graf
Article in English | LILACS | ID: biblio-1153438

ABSTRACT

Abstract The aim of present study is to characterize the resistance and virulence profile of enterococci isolated from aquaculture excavated ponds and masonry tanks (6 samples) in southern Brazil. Samples were cultured in selective medium, 10 colonies were randomly selected from each sample, which were identified by MALDI-TOF and tested against 13 antimicrobials. The presence of resistance (tetL, tetM, tetS, ermB and msrC) and virulence (ace, esp, agg, cylA and gelE) genes were determined by PCR. A total of 79 enterococci were identified, and Entecococcus faecalis (44.3%) and E. casseliflavus (36.7%) were the most prevalent species isolated. Sixty-five strains (82.3%) were resistant to at least one of the antimicrobials tested, whereas 27 (34.2%) strains were multiresistant. The overall percentages of antimicrobial resistant isolates were: 58.2% to rifampicin, 40.5% to fluoroquinolones, 36.7% to erythromycin and 30.4% to tetracycline. The tetL and tetM genes were found in 57.7% of the tetracycline-resistant strains; and msrC in 31.01% of erythromycin-resistant strains. The most frequently detected virulence factors were ace and gelE genes. Although limited to a single farm, these data suggest that aquaculture may be a reservoir of resistant and virulent enterococci. This study is the first step towards enhancing our understandingof distribution, resistance and virulence profile in enterococci isolated from fish farming environments in the south Brazil.


Resumo O objetivo do estudo apresentado é caracterizar o perfil de resistência e virulência de enterococos isolados de viveiros escavados e tanques de alvenaria (6 amostras) de uma pisicultura no Sul do Brasil. As amostras foram cultivadas em meio seletivo, 10 colônias foram selecionadas aleatoriamente de cada amostra, que foram identificadas por MALDI-TOF e testadas contra 13 antimicrobianos. A presença de genes de resistência (tetL, tetM, tetS, ermB e msrC) e virulência (ace, esp, agg, cylA e gelE) foi determinada por PCR. Foram identificados 79 enterococos, sendo Entecococcus faecalis (44,3%) e E. casseliflavus (36,7%) as espécies mais frequentes isoladas. Sessenta e cinco cepas (82,3%) eram resistentes a pelo menos um dos antimicrobianos testados, enquanto 27 (34,2%) eram multirresistentes. As porcentagens gerais de isolados resistentes a antimicrobianos foram: 58,2% para rifampicina, 40,5% para fluoroquinolonas, 36,7% para eritromicina e 30,4% para tetraciclina. Os genes tetL e tetM foram encontrados em 57,7% das cepas resistentes à tetraciclina; e msrC em 31,01% das cepas resistentes à eritromicina. Os fatores de virulência mais comumente detectados foram ace e gelE. Embora limitados a uma única fazenda, esses dados indicam que a aquicultura pode ser uma fonte de enterococos resistentes e virulentos. Este estudo é o primeiro passo para melhorar nosso entendimento da distribuição, resistência e perfil de virulência em enterococos isolados de ambientes de piscicultura no sul do Brasil.


Subject(s)
Animals , Enterococcus/genetics , Drug Resistance, Bacterial/genetics , Brazil , Microbial Sensitivity Tests , Agriculture
3.
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
4.
Clinics ; 76: e2284, 2021. tab
Article in English | LILACS | ID: biblio-1153994

ABSTRACT

OBJECTIVES: Bacterial and aseptic meningitis after neurosurgery can present similar clinical signs and symptoms. The aims of this study were to develop and test a molecular method to diagnose bacterial meningitis (BM) after neurosurgery. METHODS: A 16S ribosomal RNA gene PCR-based strategy was developed using artificially inoculated cerebrospinal fluid (CSF) followed by sequencing. The method was tested using CSF samples from 43 patients who had undergone neurosurgery and were suspected to suffer from meningitis, and from 8 patients without neurosurgery or meningitis. Patients were classified into five groups, confirmed BM, probable BM, possible BM, unlikely BM, and no meningitis. RESULTS: Among the samples from the 51 patients, 21 samples (41%) were culture-negative and PCR-positive. Of these, 3 (14%) were probable BM, 4 (19%) were possible BM, 13 (62%) were unlikely BM, and 1 (5%) was meningitis negative. Enterobacterales, non-fermenters (Pseudomonas aeruginosa and Acinetobacter baumannii), Staphylococcus haemolyticus, Granulicatella, Variovorax, and Enterococcus cecorum could be identified. In the group of patients with meningitis, a good agreement (3 of 4) was observed with the results of cultures, including the identification of species. CONCLUSION: Molecular methods may complement the diagnosis, guide treatment, and identify non-cultivable microorganisms. We suggest the association of methods for suspected cases of BM after neurosurgery, especially for instances in which the culture is negative.


Subject(s)
Humans , Meningitis, Bacterial/diagnosis , Neurosurgery , RNA, Ribosomal, 16S/genetics , Polymerase Chain Reaction , Sensitivity and Specificity , Enterococcus
5.
Infectio ; 24(4): 248-254, oct.-dic. 2020. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1114877

ABSTRACT

Resumen Introducción: las infecciones causadas por Enterococcus resistente a Vancomicina (EVR) presentan mayor mortalidad en pacientes críticos, asociado a un aumento gradual en este patrón de resistencia, especialmente en el continente americano, por lo cual la adecuada terapia antimicrobiana empírica es fundamental para mejorar los desenlaces. Objetivo: determinar los factores de riesgo asociados al desarrollo de infección por EVR en pacientes sépticos en la Unidad de Cuidados Intensivos (UCI) del Hospital San José en Bogotá, Colombia. Métodos: Estudio descriptivo de casos y controles en pacientes sépticos ingresados a la UCI durante 2016 y 2017. Los casos se definieron como pacientes con infección por EVR y los controles los pacientes con infección por otro germen. Resultados: se incluyeron 32 pacientes con aislamiento de EVR y 96 controles. Los factores de riesgo asociados a infección por EVR fueron: nutrición parenteral (OR 15,7 IC 4,2-71,4), lavado peritoneal (OR 8,9 IC 3,2-24,8), cultivo polimicrobiano (OR 19,9 IC 6,0-83,4). La mortalidad fue 56,2% en casos y 33,3% en controles. Conclusiones: Los factores de riesgo hallados con mayor frecuencia fueron: múltiples lavados peritoneales, nutrición parenteral y cultivos polimicrobianos. Encontramos una correlación significativa en el uso de antibiótico empírico adecuado y la reducción en la mortalidad.


Summary Introduction: infections caused by Vancomycin-resistant Enterococcus (VRE) have higher mortality in critically ill patients, associated with increase in this pattern of resistance, especially in the Americas, which is why adequate empirical antimicrobial therapy is essential to improve outcomes Objective: to determine the risk factors associated with the development of infection by VRE in septic patients in the Intensive Care Unit (ICU) of San José Hospital in Bogotá, Colombia. Methods: Case-control study in septic patients admitted to the ICU during 2016 and 2017. The cases were defined as patients with VRE infection and the controls were patients with infection by another germ. Results: 32 patients with EVR isolation and 96 controls were included. The risk factors associated with infection by EVR were: parenteral nutrition (OR 15.7 IC 4.2-71.4), peritoneal lavage (OR 8.9 IC 3.2-24.8), polymicrobial culture (OR 19,9 IC 6.0-83.4). Mortality was 56.2% in cases and 33.3% in controls. Conclusions: The risk factors found most frequently were: multiple peritoneal lavage, parenteral nutrition and polymicrobial cultures. We found a significant correlation in the use of adequate empirical antibiotic and the reduction in mortality


Subject(s)
Humans , Male , Female , Vancomycin , Mortality , Enterococcus , Sepsis , Infections , Intensive Care Units , Anti-Bacterial Agents
6.
Pesqui. vet. bras ; 40(10): 804-813, Oct. 2020. tab, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1143408

ABSTRACT

Bacterial resistance is shown to be an inevitable side effect due to the excessive use of antibiotics, becoming a significant concern worldwide. Knowledge of regional bacterial resistance profiles enables the development of site-specific infection control practices, making conscious and moderate use of commercially available antibiotics. The aim of this study was the retrospective evaluation of the antimicrobial resistance profile of bacteria isolated from companion animal infections in the region of Umuarama/PR, from 2013 to 2017. This research was performed by analyzing the database belonging to the "Laboratório de Microbiologia Animal" at the "Universidade Estadual de Maringá" (UEM). Staphylococcus spp. represented 45.53% of the bacteria isolated from clinical infections in small animals in the period and place evaluated, followed by enterobacteria (34.04%), non-fermenting Gram-negative bacilli (NFGNB, 11.06%) and Streptococcus/Enterococcus (9.36%). A high number of antimicrobial resistance to antibiotics used in veterinary medicine was found. The lowest resistances associated with the best impact factor values were found for aminoglycosides, especially amikacin, chloramphenicol, and fluoroquinolones (norfloxacin and ciprofloxacin). Intermediate results were found for sulbactam-associated ampicillin, ceftriaxone, amoxicillin-clavulanic acid, and enrofloxacin. According to the number of resistant antimicrobial drugs, 64.26% (151/235) of the isolates were classified as multidrug-resistant, being 15.32% extensively resistant. Considering the resistance to antimicrobial classes, 68.94% (162/235) of the isolates were classified as multiresistant, being 19.15% extensively resistant. No bacterial strains were characterized as pan-resistant, but ten bacteria were resistant to all classes tested, with isolated susceptibility to certain drugs. Through the evaluation of resistance profiles found in the period and place studied and relevant literature, it is clear that there is a growing increase in the number of multiresistant bacteria among domestic animals which characterizes a serious risk to public health. The therapeutic arsenal is becoming increasingly diminished, and there is more difficulty in empirical drug selection, making antimicrobial susceptibility testing essential for more specific selection in antimicrobial therapy. Educational measures on the conscious use of antibiotics, infection control, and prevention of local specific zoonoses need to be instituted for the knowledge of health professionals and general access of the population.(AU)


A resistência bacteriana, mostra-se como um efeito colateral inevitável pelo excessivo uso de antibióticos, tornando-se alvo de grande preocupação mundial. O conhecimento dos perfis de resistência bacteriana regionais possibilita o desenvolvimento de práticas de controle de infecções específicas para cada localidade, fazendo uso consciente e moderado dos antibióticos disponíveis no mercado. O objetivo deste estudo foi a avaliação retrospectiva do perfil de resistência antimicrobiana de bactérias isoladas de infecções de animais de companhia na região de Umuarama/PR, no período de 2013 a 2017. Esta pesquisa foi realizada por meio da análise do banco de dados pertencente ao Laboratório de Microbiologia Animal da Universidade Estadual de Maringá (UEM). Os Staphylococcus spp. representaram 45,53% das bactérias isoladas de infecções clínicas em pequenos animais no período e local avaliado, seguido por enterobactérias (34,04%), bacilos Gram-negativos não fermentados (BGNNF, 11,06%) e Streptococcus/Enterococcus (9,36%). Um número elevado de resistência antimicrobiana frente aos antibióticos utilizados na medicina veterinária foi encontrado. As menores resistências associadas aos melhores valores do fator de impacto foram encontrados para aminoglicosídeos, em especial amicacina, cloranfenicol, fluoroquinolonas (norfloxacina e ciprofloxacina). Já resultados intermediários foram encontrados para ampicilina associada a sulbactam, ceftriaxona, amoxacilina com ácido clavulônico e enrofloxacina. Conforme o número de drogas antimicrobianas resistentes, foram classificados como multirresistentes 64,26% (151/235) dos isolados, sendo 15.32% extensivamente resistentes. Já considerando a resistência a classes de antimicrobianos, 68,94% (162/235) dos isolados foram classificados como multirresistentes, sendo 19.15% extensivamente resistentes. Nenhum isolado bacteriano foi caracterizado como pan-resistente, porém 10 bactérias foram resistentes a todas as classes testadas, com susceptibilidade isolada a determinadas drogas. Por meio da avaliação dos perfis de resistência encontrados no período e local estudados e de literatura pertinente, percebe-se que há um aumento crescente no número de bactérias multirresistentes entre os animais domésticos o que caracteriza um grave risco à saúde pública. O arsenal terapêutico está se tornando cada vez mais diminuto e há mais dificuldade na seleção empírica de drogas, tornando essencial a realização de testes de susceptibilidade antimicrobiana para uma seleção mais específica na terapêutica antimicrobiana. Medidas educativas sobre o uso consciente dos antibióticos, controle de infecções e prevenção de zoonoses específicas para as localidades precisam ser instituídas para conhecimento dos profissionais do setor da saúde e acesso geral da população.(AU)


Subject(s)
Animals , Cats , Dogs , Staphylococcus/drug effects , Enterococcus/drug effects , Drug Resistance, Multiple, Bacterial , Enterobacteriaceae/drug effects
7.
Pesqui. vet. bras ; 40(2): 129-133, Feb. 2020. tab
Article in English | LILACS, VETINDEX | ID: biblio-1098445

ABSTRACT

Enterococcus are recognized worldwide as significant nosocomial agents that have been continuously envolving to adapt to different niches and acquire resistance to several antibiotic classes. Vancomycin and gentamicin-resistant strains of E. faecalis and E. faecium have been associated with nosocomial human infections. Some epidemiological studies suggest the participation of pets as reservoirs of vancomycin and gentamicin-resistant Enterococcus strains. However, the role of companion birds as reservoirs of these strains has been poorly studied. In this study, 126 psittacine birds were evaluated and 26.9% carried Enterococcus spp., including the species E. faecalis, E. faecium, E. hirae, E. phoeniculicola, E. gallinarum and E. casseliflavus. The antibiotic resistance profile showed four high-level gentamicin-resistance (HLGR) strains. In addition, two strains presented intermediate levels of vancomycin resistance. Resistant strains were isolated from fecal and oropharynx samples of sick and clinically healthy birds, suggesting that psittacine birds may act as reservoirs of HLGR Enterococcus spp. However, sick birds appear to be more implicated in the enterococci transmission than healthy birds.(AU)


Enterococcus são reconhecidos mundialmente como significantes agentes nosocomiais, que têm continuamente se adaptado a diferentes nichos e adquirido resistência a várias classes de antibióticos. Cepas de E. faecalis e E. faecium vancomicina e gantamicina-resistentes têm sido associadas a infecções nosocomiais em humanos. Alguns estudos epidemiológicos sugerem a participação de aves como reservatórios de cepas de Enterococcus vancomicina e gentamicina-resistentes. Entretanto, a relação das aves de companhia como reservatórios destas cepas tem sido pouco estudada. Neste estudo, 126 psitacídeos foram avaliados, e 26,9% destes eram portadores de Enterococcus spp., incluindo as espécies E. faecalis, E. faecium, E. hirae, E. phoeniculicola, E. gallinarum e E. casseliflavus. O perfil de resistência antibiótica mostrou quatro cepas com alto nível de resistência a gentamicina (ANRG). Além de duas cepas com nível intermediário de resistência a vancomicina. As cepas resistentes foram isoladas de amostras fecais e de orofaringe de aves doentes e clinicamente saudáveis, sugerindo que psitacídeos podem estar atuando como reservatórios para Enterococcus spp. com ANRG. Contudo, Aves doentes parecem estar mais relacionadas à transmissão de enterococcus, do que aves saudáveis.(AU)


Subject(s)
Animals , Parrots/microbiology , Disease Reservoirs/veterinary , Gentamicins , Vancomycin Resistance , Drug Resistance, Bacterial , Pets/microbiology , Enterococcus/isolation & purification
8.
Santa Tecla, La Libertad; ITCA Editores; ene. 2020. 66 p. ^c28 cm.tab., graf..
Monography in Spanish | LILACS, BISSAL | ID: biblio-1222759

ABSTRACT

Este estudio permitió conocer la calidad microbiológica del agua del Golfo de Fonseca, a través de un programa de monitoreo realizado durante 12 meses, en 9 puntos de muestreo distribuidos en 3 sectores. "A" estero La Manzanilla-Isla Perico, "B" Ciudad de La Unión ­ bocana río Goascorán y "C" estero El Tamarindo ­ Isla Meanguera. El propósito fue obtener registros de contaminación de aguas costeras para el país y el impacto que las aguas residuales producen en el ambiente costero y la pérdida de la calidad del agua para actividades tales como la maricultura y la recreación. Entre las bacterias encontradas se encuentran: Enterococcus, Pseudomonas, Vibrios y Heterótrofas. Dichas bacterias están asociadas con diferentes enfermedades para la salud humana, tal es el caso de las pseudomonas, las cuales están frecuentemente asociadas a infecciones de los tractos respiratorio y urinario. Los resultados obtenidos de Vibrio indican que el agua no es apta para uso en acuicultura, ni para uso recreativo, el agua se encuentra en el límite de referencia en cuanto al uso con propósito de producción acuícola y límite de referencia en cuanto al riesgo de consumo de productos pesqueros.


This study allowed to know the microbiological quality of the water of Golfo de Fonseca, through a monitoring program carried out during 12 months, in 9 sampling points distributed in 3 sectors. "A" La Manzanilla estuary- Isla Perico, "B" City of La Unión - Río Goascorán mouth and "C" El Tamarindo estuary - Isla Meanguera. The purpose was to obtain records of coastal water pollution for the country and the impact that wastewater produces on the coastal environment and the loss of water quality for activities such as mariculture and recreation. Among the bacteria found are: Enterococcus, Pseudomonas, Vibrios and Heterotrophs. These bacteria are associated with different diseases for human health, such is the case of pseudomonas, which are frequently associated with infections of the respiratory and urinary tracts. The results obtained from Vibrio indicate that the water is not suitable for use in aquaculture, nor for recreational use, the water is at the reference limit in terms of use for the purpose of aquaculture production and the reference limit regarding the risk of consumption. of fishery products.


Subject(s)
Bacteria , Water Quality , Water Quality Criteria , Water , Aquaculture , Pseudomonas , Vibrio , Enterococcus , Waste Water , Fisheries , Sustainable Development
9.
Article in English | WPRIM | ID: wpr-816604

ABSTRACT

BACKGROUND: The weather has well-documented effects on infectious disease and reports suggest that summer peaks in the incidences of gram-negative bacterial infections among hospitalized patients. We evaluated how season and temperature changes affect bloodstream infection (BSI) incidences of major pathogens to understand BSI trends with an emphasis on acquisition sites.METHODS: Incidence rates of BSIs by Staphylococcus aureus, Enterococcus spp., Escherichia coli, Klebsiella pneumoniae, Acinetobacter spp., and Pseudomonas aeruginosa were retrospectively analyzed from blood cultures during 2008–2016 at a university hospital in Seoul, Korea according to the acquisition sites. Warm months (June–September) had an average temperature of ≥20℃ and cold months (December–February) had an average temperature of ≤5℃.RESULTS: We analyzed 18,047 cases, where 43% were with community-onset BSI. E. coli (N = 5,365) was the most common pathogen, followed by Enterococcus spp. (N = 3,980), S. aureus (N = 3,075), K. pneumoniae (N = 3,043), Acinetobacter spp. (N = 1,657), and P. aeruginosa (N = 927). The incidence of hospital-acquired BSI by Enterococcus spp. was weakly correlated with temperature, and the median incidence was higher during cold months. The incidence of community-onset BSI by E. coli was higher in warm months and was weakly correlated with temperature.CONCLUSION: We found seasonal or temperature-associated variation in some species-associated BSIs. This could be a useful information for enhancing infection control and public health policies by taking season or climate into consideration.


Subject(s)
Acinetobacter , Climate , Climate Change , Communicable Diseases , Enterococcus , Escherichia coli , Gram-Negative Bacterial Infections , Humans , Incidence , Infection Control , Klebsiella pneumoniae , Korea , Pneumonia , Pseudomonas aeruginosa , Public Health , Retrospective Studies , Seasons , Seoul , Staphylococcus aureus , Tertiary Care Centers , Weather
10.
Rev. odontopediatr. latinoam ; 10(1): 54-64, 2020. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1147435

ABSTRACT

Objetivos: Evaluar in vitro la acción antimicrobiana de las pastas GuedesPinto modificadas con Diprogenta® y con Otosporin®, comparándolas con la pasta Guedes-Pinto convencional. Materiales y métodos: Se evaluó la acción antimicrobiana de las pastas Guedes Pinto contra cepas aisladas de los siguientes microbios: Streptococcus mutans ATCC 25175 Staphylococcus aureus ATCC 25923, Enterococcus faecalis - ATCC 29212, Pseudomonas aeruginosa - ATCC 4116, Candida albicans ATCC 10231. Se empleó la técnica de difusión en agar por el método de pocillo y en triplicado, utilizando el digluconato de clorexidina al 0,12% como control positivo y solución salina como control negativo. Se transfirió 2 mL del inóculo producido de cada microbio a 100mL de agar fundido a 45ºC, dispensando la mezcla en 30 placas de petri. Las placas fueron mantenidas a temperatura ambiente por dos horas y luego incubadas a 35ºC por 24 y 48 horas. La lectura de los resultados fue sometida al Análisis de varianza de un factor y Test de Tukey para comparaciones múltiples. Resultados: La pasta Guedes-Pinto Convencional formó los mayores halos de inhibición para la mayoría de los microbios, con excepción de Candida albicans, donde ninguna de las sustancias produjo efecto y de la Pseudomonas aeruginosa, para la cual la pasta modificada con Diprogenta® obtuvo mejores resultados, sin diferencia estadística entre ellas. La pasta Diprogenta® presentó mejores resultados que la pasta Otosporin® para todos los demás microorganismos y esto ultimo no formó halo de inhibición para Enterococcus faecalis. Conclusión: La utilización de sustitutos de Rifocort® parece tener un potencial antimicrobiano efectivo contra los principales microbios encontrados en los canales radiculares


Objetivos: Evaluar in vitro la acción antimicrobiana de las pastas Guedes-Pinto modificadas con Diprogenta® y con Otosporin®, comparándolas con la pasta Guedes-Pinto convencional. Materiales y métodos: Se evaluó la acción antimicrobiana de las pastas Guedes Pinto contra cepas aisladas de los siguientes microbios: Streptococcus mutans ATCC 25175 Staphylococcus aureus - ATCC 25923, Enterococcus faecalis- ATCC 29212, Pseudomonas aeruginosa- ATCC 4116, Candida albicans - ATCC 10231. Se empleó la técnica de difusión en agar por el método de pocillo y en triplicado, utilizando el digluconato de clorexidina al 0,12% como control positivo y solución salina como control negativo. Se transfirió 2 mL del inóculo producido de cada microbio a 100mL de agar fundido a 45ºC, dispensando la mezcla en 30 placas de petri. Las placas fueron mantenidas a temperatura ambiente por dos horas y luego incubadas a 35ºC por 24 y 48 horas. La lectura de los resultados fue sometida al Análisis de varianza de un factor y Test de Tukey para comparaciones múltiples. Resultados: La pasta Guedes-Pinto Convencional formó los mayores halos de inhibición para la mayoría de los microbios, con excepción de Candida albicans, donde ninguna de las sustancias produjo efecto y de la Pseudomonas aeruginosa, para la cual la pasta modificada con Diprogenta® obtuvo mejores resultados, sin diferencia estadística entre ellas. La pasta Diprogenta® presentó mejores resultados que la pasta Otosporin® para todos los demás microorganismos y esto ultimo no formó halo de inhibición para Enterococcus faecalis. Conclusión: La utilización de sustitutos de Rifocort®parece tener un potencial antimicrobiano efectivo contra los principales microbios encontrados en los canales radiculares.


Objetivos: avaliar in vitro a ação antimicrobiana das pastas Guedes-Pinto modificadas com Diprogenta® e com Otosporin®, comparando-as com a pasta Guedes-Pinto convencional. Material e métodos: A ação antimicrobiana das pastas foi testada contra cepas isoladas dos seguintes microorganismos: Streptococcus mutans ATCC 25175 Staphylococcus aureus - ATCC 25923, Enterococcus faecalis - ATCC 29212, Pseudomonas aeruginosa - ATCC 4116, Candida albicans - ATCC 10231. Foi empregada a técnica de difusão em ágar pelo método de poço e em triplicata, utilizando-se o digluconato de clorexidina a 0,12% como controle positivo e solução salina como controle negativo. Foi transferido 2mL do inóculo produzido de cada microorganismo para 100mL de ágar fundido a 45ºC, dispensando a mistura em 30 placas de petri. As placas foram mantidas à temperatura ambiente por duas horas e depois incubadas a 35ºC por 24 e 48 horas. A leitura dos resultados foi submetida à Análise de variância de um fator e Teste de Tukey para comparações múltiplas. Resultados: A pasta Guedes-Pinto Convencional formou os maiores halos de inibição para a maioria dos microorganismos, com exceção da Candida albicans, onde nenhuma das substancias produziu efeito e da Pseudomonas aeruginosa, para qual a pasta modificada com Diprogenta®obteve melhores resultados, apesar de não haver diferença estatística entre elas. A pasta com Diprogenta® apresentou melhores resultados que a pasta com Otosporin® para todos os demais microrganismos e esta não formou halo de inibição para o Enterococcus faecalis. Conclusão: A utilização de substitutos do Rifocort® parece ter potencial antimicrobiano efetivo contra os principais microorganismos encontrados nos canais radiculares.


Subject(s)
Humans , Toothpastes , Analysis of Variance , Pseudomonas aeruginosa , Staphylococcus aureus , Streptococcus mutans , In Vitro Techniques , Candida albicans , Enterococcus , Enterococcus faecalis , Materials , Saline Solution , Methods , Anti-Infective Agents
11.
Rev. chil. infectol ; 36(6): 687-697, dic. 2019. tab
Article in Spanish | LILACS | ID: biblio-1058100

ABSTRACT

Resumen Introducción: Vancomicina, terapia estándar para enterococos y estafilococos resistentes a β-lactámicos tradicionales (Staphylococcus aureus [SARM] y Staphylococcus coagulasa negativa), tiene extenso uso empírico en infecciones nosocomiales. Farmacológicamente débil, de estrecho margen terapéutico y farmacocinética poco predecible, es un fármaco sub-estándar según criterios contemporáneos. Tiene excesivo uso, por sobrediagnóstico de infecciones bacterianas y, en infecciones genuinas, por sobre-estimación etiológica de patógenos β-lactámico-resistentes. Últimamente han surgido nuevas amenazas a su efectividad: peores desenlaces en infecciones por SARM con CIM en rango alto de sensibilidad y resistencia de enterococos. Hay frecuente administración inadecuada en: dosis e intervalos, ausencia de dosis de carga inicial, falta de monitoreo con concentraciones plasmáticas, inadecuada dosificación en presencia de insuficiencia renal o diálisis e, importantemente, mantención de uso en ausencia de clara documentación de su necesidad. Nuevos fármacos anti-estafilocócicos no han permitido un reemplazo generalizado de vancomicina por lo que ésta mantiene un importante rol en la medicina contemporánea. Conclusiones: Una comprensión de las fortalezas y debilidades del fármaco, así como de la cambiante epidemiología y propiedades microbiológicas de los patógenos relevantes, al igual que un uso prudente y selectivo, permitirán optimizar su uso y mantener su rol terapéutico en la medicina actual y futura.


Background: Vancomycin, standard parenteral therapy for Gram positive cocci resistant to traditional beta-lactam antibiotics (Staphylococcus aureus and coagulase negative staphylococci [CNS]) and Enterococcus spp, frequent agents of nosocomial infections, is extensively used empirically in that setting. However, its pharmacological weakness, narrow therapeutic margin and poorly predictable pharmacokinetics, make it a suboptimal drug according to contemporary criteria. Vancomycin is over utilized due to both, overestimation of bacterial infections and, in genuine cases, overestimation of the etiological role of these resistant cocci, either nosocomially or community acquired. New threats narrow further its therapeutic role: poorer outcomes in infections with higher vancomycin MIC and resistance by enterococci. It is frequently given at inappropriate dosage and intervals, failing to: give loading dose when recommended, measure blood levels, adjust dosing to changing renal function and continued use when not necessary. Newer anti staphylococcal drugs haven't replaced completely the role of vancomycin, which maintains its usefulness in contemporary medicine. Conclusion: Understanding the strengths and weaknesses of vancomycin, current epidemiology and microbiology of infections for which it may be indicated, as well as the proper administration and monitoring, together with a prudent and selective indication will allow to preserve its present and future utility in the changing medical scenario.


Subject(s)
Humans , Staphylococcal Infections/drug therapy , Vancomycin , Staphylococcus , Microbial Sensitivity Tests , Enterococcus , Anti-Bacterial Agents/therapeutic use
12.
Rev. chil. infectol ; 36(5): 556-564, oct. 2019. tab
Article in Spanish | LILACS | ID: biblio-1058081

ABSTRACT

Resumen Durante las últimas décadas, especies del género Enterococcus han emergido como importantes agentes etiológicos de bacteriemia, osteomielitis, endocarditis e infecciones de tejidos blandos. La combinación de antibacterianos ha sido la estrategia terapéutica más utilizada para dichas infecciones, buscando un potencial efecto sinérgico bactericida. Sin embargo, aparte de los modelos in vitro e in vivo, la utilidad clínica del tratamiento combinado genera controversia, especialmente en infecciones sistémicas no endocárdicas. Aunque las combinaciones entre β-lactámicos y aminoglucósidos o el tratamiento dual con β-lactámicos, han mejorado las tasas de curación de la endocarditis, aún no se ha esclarecido cuál es su tratamiento óptimo o si estas combinaciones también son útiles en otro tipo de infecciones graves sistémicas. El propósito de esta revisión es analizar y resumir los resultados obtenidos de diferentes modelos experimentales de combinaciones anti-enterocócicas y de los estudios clínicos disponibles en PubMed/Medline, a fin de evaluar mejor la evidencia que soporta la utilización de estas combinaciones. En conclusión, la información disponible es escasa, e indica la necesidad de mejores modelos in vivo y estudios clínicos que permitan comprobar la potencial actividad sinérgica de las combinaciones anti-enterocóciccas.


During the last decades, enterococci have emerged as important etiological agents in bacteremia, osteomyelitis, endocarditis and soft tissue infections. Antimicrobial combinations have been the most used therapeutic strategies for these infections, aiming for a bactericidal synergistic effect. However, besides in vitro and in vivo models, the clinical usefulness of such combinations is controversial, especially in non-endocardic systemic infections. For example, although beta-lactam and aminoglycoside combinations or double beta-lactam treatment have achieved high cure rates in endocarditis, the optimal treatment has not yet been clarified or if these combinations are useful in other infections. The aim of this review was to analyze and summarize the results from several experimental models of antienterococcal combined therapy and from clinical trials available in PubMed/Medline, to better assess the evidence that supports the use of these combinations. In conclusion, the available information is scarce, and more and better in vivo models and clinical studies are required to confirm the potential synergistic activity of antienterococcal combinations.


Subject(s)
Humans , Gram-Positive Bacterial Infections/drug therapy , Enterococcus/drug effects , Anti-Bacterial Agents/pharmacology , Reproducibility of Results , Clinical Trials as Topic , Treatment Outcome , Drug Synergism , Drug Therapy, Combination , Endocarditis/chemically induced
13.
Article in English | WPRIM | ID: wpr-719650

ABSTRACT

BACKGROUND: Enterococcus faecalis strains with low-level resistance to linezolid (an oxazolidinone antibiotic) have become common. No large-scale study has examined the underlying mechanisms in linezolid-resistant E. faecalis (LRE) strains. We investigated these mechanisms and molecular characteristics in Chongqing, China. METHODS: A total of 1,120 non-duplicated E. faecalis strains collected from August 2014 to June 2017 underwent drug susceptibility testing. LRE strains were screened for optrA, cfr, and mutations in the 23S rRNA and ribosomal proteins L3 and L4 by PCR amplification and sequencing. Multi-locus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) were used for epidemiological analysis. RESULTS: All 43 low-level LRE strains (minimum inhibitory concentration: 8–16 mg/L) harbored optrA; cfr and 23S rRNA mutations were not detected. Novel mutations in the ribosomal proteins L3 and L4—one deletion (Q103del) and four substitutions (S113L, T35A, I98V, and N79D)—were identified. Novel amino acid substitutions at positions E60K, G197D, and T285P of the OptrA protein were observed. MLST revealed 20 types of LRE strains; the most common type was ST16 (32.6%). PFGE showed 14 strains of ST16 with unique banding patterns. Eight novel sequence types (ST823 to ST830) and one allele (gki95) were identified for the first time in China. CONCLUSIONS: optrA plays an important role in linezolid resistance and may serve as a marker for resistance screening. Since the L3 and L4 mutations did not simultaneously occur in the same strain, they play a negligible role in linezolid resistance. Epidemiological investigation suggested that the LRE cases were sporadic.


Subject(s)
Alleles , Amino Acid Substitution , China , Electrophoresis, Gel, Pulsed-Field , Enterococcus faecalis , Enterococcus , Epidemiology , Linezolid , Mass Screening , Molecular Epidemiology , Polymerase Chain Reaction , Ribosomal Proteins
15.
Article in English | WPRIM | ID: wpr-760489

ABSTRACT

BACKGROUND: Blood culture is an important method for identifying infectious microorganisms and confirming that a selected antimicrobial treatment is appropriate. In this study, we investigated the annual changes in the frequencies of blood isolates and antibiotic susceptibility test (AST) results. METHODS: We created a large database comprising data on all patient-unique blood cultures obtained from January 2007 through December 2016. Blood specimens were cultured using the BD BACTEC FX system, and species identification and AST were performed using the VITEK 2 system. RESULTS: During the 10-year study period, a total of 203,651 blood culture results were collected. Of these, gram-positive cocci, gram-negative rods, and fungi were isolated in 2.15%, 0.55%, and 0.12% of the blood cultures, respectively. Escherichia coli was the most commonly isolated species (22.8%), followed by Staphylococcus epidermidis (16.8%), Klebsiella pneumoniae (8.1%), and Staphylococcus aureus (8.0%). Fungal species were isolated in 3.0% of all positive blood cultures. Candida albicans was the most commonly isolated species (1.1%), followed by Candida parapsilosis (0.6%). Methicillin resistance was seen in 55.2% of S. aureus isolates. The frequencies of vancomycin-resistant Enterococcus (VRE) and carbapenem-resistant Pseudomonas aeruginosa (CRPA) were 13.1% and 10.9%, respectively. The isolation rates of MRSA, VRE, and CRPA showed different patterns each year. CONCLUSIONS: Among the isolates, E. coli was the most common, followed by S. epidermidis and K. pneumoniae. This study represents a long-term analysis of bloodstream infections, and the results can be used to identify trends in the microorganisms isolated and their drug resistance.


Subject(s)
Bacteremia , Candida , Candida albicans , Drug Resistance , Enterococcus , Escherichia coli , Fungi , Gram-Positive Cocci , Klebsiella pneumoniae , Korea , Methicillin Resistance , Methicillin-Resistant Staphylococcus aureus , Methods , Pneumonia , Pseudomonas aeruginosa , Staphylococcus aureus , Staphylococcus epidermidis
16.
Article in English | WPRIM | ID: wpr-758912

ABSTRACT

Enterococcus spp. are opportunistic pathogens that cause lameness in broiler chickens, resulting in serious economic losses worldwide. Virulence of Enterococcus spp. is associated with several putative virulence genes including fsr, efm, esp, cylA, cad1, ace, gelE, and asa1. In this study, multiplex polymerase chain reaction (PCR) for the simultaneous detection of these virulence genes in Enterococcus spp. was developed, and detection limits for E. faecium, E. faecalis, and E. hirae were 64.0 pg/µL, 320.0 pg/µL, and 1.6 ng/µL DNA, respectively. Among 80 Enterococcus isolates tested, efm and cad1 were detected in all 26 E. faecium samples, and only cad1 was observed in E. hirae. Additionally, the presence of virulence genes in 25 E. faecalis isolates were 100% for cad1, 88.0% for gelE, 64.0% for fsr, 44.0% for asa1, 16.0% for cylA, and 4.0% for esp. No virulence genes were found in E. gallinarum isolates. A total of 49 isolates were resistant to tigecycline and to at least 2 different classes of antibiotics. The most prevalent resistance was to ciprofloxacin (73.5%), quinupristin/dalfopristin (55.1%), and tetracycline (49.0%). No strains were resistant to vancomycin or linezolid. This is the first multiplex PCR assay to simultaneously detect eight virulence genes in Enterococcus spp., and the method provides diagnostic value for accurate, rapid, and convenient detection of virulence genes. Additionally, we report the prevalence of virulence genes and antimicrobial resistance in Enterococcus isolates from commercial broiler chickens suffering lameness.


Subject(s)
Anti-Bacterial Agents , Chickens , Ciprofloxacin , DNA , Drug Resistance, Microbial , Enterococcus , Limit of Detection , Linezolid , Methods , Multiplex Polymerase Chain Reaction , Prevalence , Tetracycline , Vancomycin , Virulence
17.
Article in English | WPRIM | ID: wpr-758895

ABSTRACT

Isolates of 24 enterococci, 5 Enterococcus casseliflavus and 19 Enterococcus gallinarum, possessing vanC genes and showing low-level resistance to vancomycin were obtained from mice from commercial mouse breeding companies. Since some of these isolates showed resistance to other antibiotics, the purpose of this study was to clarify the resistant profiles of these isolates. One E. casseliflavus isolate showed resistance to erythromycin with a minimal inhibitory concentration (MIC) of 8 μg/mL and also showed apparent resistance to fluoroquinolones with an MIC of 32 μg/mL for ciprofloxacin. The MICs of 2 other fluoroquinolone-resistant E. casseliflavus and E. gallinarum isolates were 3 and 6 μg/mL, respectively. These 3 resistant isolates showed an absence of macrolide- and fluoroquinolone-resistant genes, including amino acid substitutions in the quinolone resistance determining regions of DNA gyrase and topoisomerase IV. Resistance to tetracycline was detected in 2 E. gallinarum isolates that were highly resistant, exhibiting MICs of 48 and 64 μg/mL and possessing tet(O) genes. The results indicate that antibiotic-resistant enterococci are being maintained in some laboratory mouse strains that have never been treated with an antibiotic.


Subject(s)
Amino Acid Substitution , Animals , Anti-Bacterial Agents , Breeding , Ciprofloxacin , DNA Gyrase , DNA Topoisomerase IV , Drug Resistance, Microbial , Enterococcus , Erythromycin , Fluoroquinolones , Mice , Tetracycline , Vancomycin
19.
Article in English | WPRIM | ID: wpr-739119

ABSTRACT

We investigated the usefulness of age-specific cutoffs for screening of urinary tract infections (UTIs) in Korean outpatients, using the automated urine analyzer UF-1000i (Sysmex, Kobe, Japan). We retrospectively reviewed outpatient medical records. Urine samples of 7,443 outpatients from January 2010 to December 2017 were analyzed using urine culture and UF-1000i. ROC curves were calculated for each UF-1000i parameter based on the culture results. There were 1,398 culture positive samples, 5,774 culture negative samples, and 271 contaminated samples. UF-1000i had an area under the curve of ≥0.9 in outpatients >15 years. The appropriate cutoffs, which are the sum of bacterial (B-A-C) and white blood cell (WBC) counts, were 297.10/µL (15–24 years), 395.65/µL (25–44 years), 135.65/µL (45–64 years), 67.95/µL (65–74 years), and 96.5/µL (≥75 years). B-A-C and WBC counts differed among the three most frequently identified bacteria (Escherichia coli, Klebsiella pneumoniae, and Enterococcus faecalis). The UF-1000i system is useful for applying age-specific cutoffs to screen for UTIs, thereby preventing antibiotic abuse and reducing antibiotic resistance. Future studies can explore how its B-A-C and WBC counts can facilitate selection of empirical antibiotics by distinguishing between gram-positive and gram-negative bacteria.


Subject(s)
Anti-Bacterial Agents , Bacteria , Drug Resistance, Microbial , Enterococcus , Gram-Negative Bacteria , Humans , Klebsiella pneumoniae , Leukocytes , Mass Screening , Medical Records , Outpatients , Retrospective Studies , ROC Curve , Urinary Tract Infections , Urinary Tract
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