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1.
Braz. j. biol ; 84: e254816, 2024. tab, graf
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1355894

ABSTRACT

Abstract Pakistan is an agricultural country and fisheries play a very important role in the economic development of the country. Different diseases are prevalent in Pakistani fish but information related to the causative agents is not well-known. Keeping in view the significance of bacterial pathogens as the causative agents of multiple fish diseases, the present study was conducted for identification, characterization and analysis of virulence genes of Aeromonas spp. isolated from diseased fishes. A total of fifty fish samples having multiple clinical indications were collected from different fish farms of district Kasur, Punjab Pakistan. For isolation of Aeromonas spp. samples were enriched and inoculated on Aeromonas isolation medium. Isolates were identified and characterized by different biochemical tests, Analytical Profile Index (API) 20E kit and Polymerase Chain Reaction (PCR) assays. All isolates were screened for three putative virulence genes including aerolysin (aer), haemolysin (hyl) and heat labile cytotonic enterotoxin (alt). Seven isolates of Aeromonas (A.) hydrophila were retrieved and identified based on API 20E. These isolates were further confirmed as A. hydrophila on the basis of PCR assays. Three isolates were detected positive for the presence of virulence genes (alt and hyl). Whereas aerolysin (aer) gene was not present in any of A. hydrophila isolates. The present study confirmed A. hydrophila as the causative agent of epizootic ulcerative syndrome and motile Aeromonas septicemia in fish farms of district Kasur, Punjab Pakistan. Moreover, detection of two virulence genes (alt and hyl) in A. hydrophila isolates is a threat for fish consumers of study area.


Resumo O Paquistão é um país agrícola, onde a pesca desempenha um papel muito importante para o desenvolvimento econômico. Diferentes doenças são prevalentes em peixes do Paquistão, mas as informações relacionadas aos agentes causadores não são bem conhecidas. Tendo em vista a importância dos patógenos bacterianos como agentes causadores de múltiplas doenças em peixes, o presente estudo foi conduzido para identificação, caracterização e análise de genes de virulência de isolados de Aeromonas spp. de peixes doentes. Foram coletadas 50 amostras de peixes com múltiplas indicações clínicas em diferentes fazendas do distrito de Kasur, Punjab, Paquistão. Para isolar Aeromonas spp., as amostras foram enriquecidas e inoculadas em meio de isolamento. Os isolados foram identificados e caracterizados por diferentes testes bioquímicos, kit Analytical Profile Index (API) 20E, e ensaios de reação em cadeia da polimerase (PCR). Todos os isolados foram selecionados para três genes de virulência putativos, incluindo aerolisina (aer), hemolisina (hyl) e enterotoxina citotônica termolábil (alt). Sete isolados de Aeromonas hydrophila foram recuperados e identificados com base no API 20E. Esses isolados foram posteriormente confirmados como A. hydrophila de acordo com ensaios de PCR. Três isolados indicaram a presença de genes de virulência (alt e hyl), enquanto o gene aerolisina (aer) não esteve presente em nenhum dos isolados de A. hydrophila. O presente estudo confirmou A. hydrophila como o agente causador da síndrome ulcerativa epizoótica e septicemia móvel por Aeromonas em fazendas de peixes, no distrito de Kasur, Punjab, Paquistão. Além disso, a detecção de dois genes de virulência (alt e hyl) em isolados de A. hydrophila é uma ameaça para os consumidores de peixes da área de estudo.


Subject(s)
Animals , Gram-Negative Bacterial Infections/veterinary , Gram-Negative Bacterial Infections/epidemiology , Aeromonas/genetics , Pakistan , Aeromonas hydrophila/genetics , Enterotoxins/genetics , Fishes
2.
Braz. j. biol ; 83: e239323, 2023. tab, graf
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1339341

ABSTRACT

Abstract The β-lactam/lactamase inhibitors (BLBLIs) combination drugs are considered an effective alternative to carbapenems. However, there is a growing concern that the increased use of BLBLIs may lead to increased resistance. This study determined the temporal association between the consumption of BLBLI and the antimicrobial resistance in Gram-negative bacteria. In this retrospective study, electronic data on the Gram-negative bacterial isolates, including A. baumannii, P. aeruginosa, E. coli, and K. pneumoniae from in-patients and susceptibility testing results were retrieved from the medical records of the clinical laboratory. A linear regression and cross-correlation analysis were performed on the acquired data. Increasing trends (p<0.05) in the consumption of BIBLI and carbapenem with a median use of 27.68 and 34.46 DDD/1000 PD per quarter were observed, respectively. A decreased trend (p=0.023) in the consumption of fluoroquinolones with a median use of 29.13 DDD/1000 PD per quarter was observed. The resistance rate of K. pneumoniae was synchronized with the BIBLI and carbapenem consumptions with a correlation coefficient of 0.893 (p=0.012) and 0.951 (p=0.016), respectively. The cross-correlation analysis against the consumption of BIBLI and meropenem resistant K. pneumoniae was peaked at 0-quarter lag (r=951, p=0.016). There was an increasing trend in the consumption of BLBLI and carbapenems. The increasing trend in the rates of resistance to piperacillin/tazobactam, in line with the increasing consumption of BLBLI, suggests that BLBLI has to be used with caution and cannot be directly considered as a long-term alternative to carbapenems.


Resumo Os medicamentos combinados de β-lactâmicos / inibidores da lactamase (BLBLIs) são considerados uma alternativa eficaz aos carbapenêmicos. No entanto, existe uma preocupação crescente de que o aumento do uso de BLBLIs pode levar ao aumento da resistência. Este estudo determinou a associação temporal entre o consumo de BLBLI e a resistência antimicrobiana em bactérias gram-negativas. Neste estudo retrospectivo, os dados eletrônicos sobre as bactérias gram-negativas isoladas, incluindo A. baumannii, P. aeruginosa, E. coli e K. pneumoniae de pacientes internados e os resultados dos testes de suscetibilidade foram recuperados dos registros médicos do laboratório clínico. Uma regressão linear e análise de correlação cruzada foram realizadas nos dados adquiridos. Foram observadas tendências crescentes (p < 0,05) no consumo de BIBLI e carbapenem com uma mediana de uso de 27,68 e 34,46 DDD/1000 PD por trimestre, respectivamente. Foi observada uma tendência de diminuição (p = 0,023) no consumo de fluoroquinolonas com uma mediana de uso de 29,13 DDD/1000 PD por trimestre. A taxa de resistência de K. pneumoniae foi sincronizada com os consumos de BIBLI e carbapenem com coeficiente de correlação de 0,893 (p = 0,012) e 0,951 (p = 0,016), respectivamente. A análise de correlação cruzada contra o consumo de BIBLI e K. pneumoniae resistente ao meropenem atingiu o pico no intervalo de 0 quarto (r = 951, p = 0,016). Houve uma tendência de aumento no consumo de BLBLI e carbapenêmicos. A tendência crescente nas taxas de resistência a piperacilina/tazobactam, em linha com o consumo crescente de BLBLI, sugere que BLBLI deve ser usado com cautela e não pode ser considerado diretamente como alternativa de longo prazo aos carbapenêmicos.


Subject(s)
Humans , Gram-Negative Bacterial Infections , Gram-Negative Bacterial Infections/epidemiology , Anti-Bacterial Agents/therapeutic use , Microbial Sensitivity Tests , Retrospective Studies , Escherichia coli , Gram-Negative Bacteria
3.
Rev. bras. parasitol. vet ; 28(4): 728-734, Oct.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1057990

ABSTRACT

Abstract Free-ranging and feral dogs represent a group of unattended companion animals. They impact wild animal populations by predating native species, displacing predators and introducing exotic pathogens. The aim of this work was to describe the molecular occurrence of Rickettsia, Ehrlichia, Anaplasma, Mycoplasma and Bartonella in feral dogs. The study was carried out in the last relict of a protected area in Mexico City. Blood clots samples from 19 dogs were obtained and analyzed for detection of specific fragments of the 16S-rRNA gene for Anaplasma, Ehrlichia and Mycoplasma and citrate synthase (gltA) for Bartonella and Rickettsia. Our results showed that DNA from three bacteria species (Bartonella vinsonii subsp. berkhoffii, Ehrlichia canis and Mycoplasma haemocanis) was present with frequencies ranging from 5.3 to 15.8%. This is the first record of B. vinsonii subsp. berkhoffii and M. haemocanis in dogs from México, and also the first finding of Ehrlichia canis in Mexico City. It is important to perform surveillance of feral dog populations in order to identify the impact of these pathogens on wild animal populations and Public Health in order to establish prevention and protection programs.


Resumo Cães errantes e selvagens representam um grupo de animais de companhia livres. Eles impactam as populações de animais selvagens pela predação de espécies nativas, deslocando predadores e introduzindo patógenos exóticos. O objetivo deste trabalho foi descrever a ocorrência molecular de Rickettsia, Ehrlichia, Anaplasma, Mycoplasma e Bartonella em cães selvagens. O estudo foi realizado no último ecossistema de uma área protegida na Cidade do México. Amostras de coágulos sanguíneos de 19 cães foram obtidas e analisadas para detecção de fragmentos específicos do gene 16S-rRNA para Anaplasma, Ehrlichia e Mycoplasma e citrato sintase (gltA) para Bartonella e Rickettsia. Nossos resultados mostraram que o DNA de três espécies de bactérias (Bartonella vinsonii subsp. berkhoffii, Ehrlichia canis e Mycoplasma haemocanis) estava presente com frequências variando de 5,3 a 15,8%. Este é o primeiro registro de B. vinsonii subsp. berkhoffii e M. haemocanis em cães do México, e também a primeira descrição de Ehrlichia canis na Cidade do México. É importante realizar a vigilância das populações de cães selvagens para identificar o impacto desses patógenos nas populações de animais silvestres e na Saúde Pública, a fim de estabelecer programas de prevenção e proteção.


Subject(s)
Animals , Male , Female , Dogs , Rickettsia/isolation & purification , Bartonella/isolation & purification , Gram-Negative Bacterial Infections/veterinary , Dog Diseases/microbiology , Ehrlichia/isolation & purification , Anaplasma/isolation & purification , Mycoplasma/isolation & purification , Phylogeny , Rickettsia/genetics , Bartonella/genetics , Gram-Negative Bacterial Infections/microbiology , Gram-Negative Bacterial Infections/epidemiology , Dog Diseases/epidemiology , Ehrlichia/genetics , Anaplasma/genetics , Animals, Wild , Mexico/epidemiology , Mycoplasma/genetics
4.
Arch. argent. pediatr ; 117(1): 6-11, feb. 2019. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-983770

ABSTRACT

Introducción. Las infecciones por bacilos Gram-negativos multirresistentes (BGN-MR) constituyen un problema creciente en las unidades de cuidado intensivo neonatal. El objetivo del estudio fue conocer las características epidemiológicas, clínicas, microbiológicas, evolutivas y los factores de riesgo de infección por BGN-MR resistentes a carbapenemes en el Servicio de Neonatología de un hospital de alta complejidad. Población y método. Se realizó un estudio de cohorte retrospectivo en dicho Servicio, donde se incluyeron los pacientes con infección documentada por BGN-MR del 24/4/2013 al 29/4/2015. Resultados. Se incluyeron 21 pacientes. La mediana de edad gestacional y peso de nacimiento fue 35 semanas y 2070 gramos, respectivamente. Dieciocho pacientes (86 %) tuvieron hemocultivos positivos y el aislamiento microbiológico más frecuente fue Acinetobacter baumannii (17 pacientes, 81 %), seguido por Klebsiella pneumoniae productora de carbapenemasa (3 pacientes, 14 %) y Enterobacter cloacae (1 paciente, 5 %). La mediana de edad al momento del diagnóstico fue de 28 días y todos tenían factores de riesgo para la infección, como cirugía, asistencia respiratoria mecánica, nutrición parenteral, catéter central y antibióticos. El tratamiento antibiótico definitivo fue colistina en todos los casos, combinado en el 84 %. Cinco pacientes (24 %) fallecieron por la infección. La prematurez y el peso < 2000 g fueron factores de riesgo estadísticamente significativos asociados a la mortalidad (p = 0,03 y 0,01, respectivamente). Conclusión. Las infecciones por BGN-MR se presentaron en pacientes con factores predisponentes. Acinetobacter baumannii fue el primer agente etiológico. La mortalidad fue elevada y relacionada con prematurez y bajo peso al nacer.


Introduction. Multidrug resistant Gramnegative (MDRGN) infections are an increasing problem in neonatal intensive care units. The objective of this study was to establish the epidemiological, clinical, microbiological, and evolutionary characteristics of carbapenem-resistant MDRGN infections and the risk factors for them at the Division of Neonatology of a tertiary care hospital. Population and method. A retrospective cohort study was done in this Division in patients with a documented MDRGN infection between 4/24/2013 and 4/29/2015. Results. Twenty-one patients were included. Their median gestational age and birth weight were 35 weeks and 2070 g, respectively. Eighteen patients (86 %) had a positive blood culture; the most commonly isolated microorganism was Acinetobacter baumannii (17 patients, 81 %), followed by carbapenemase-producing Klebsiella pneumoniae (3 patients, 14 %) and Enterobacter cloacae (1 patient, 5 %). The median age at diagnosis was 28 days and all patients had risk factors for infection, including surgery, assisted mechanical ventilation, parenteral nutrition, central venous line, and antibiotics. The definite antibiotic therapy included colistin in all cases; in combination, in 84 %. Five patients (24 %) died due to the infection. Prematurity and a birth weight < 2000 g were statistically significant risk factors associated with mortality (p = 0.03 and 0.01, respectively). Conclusion. MDRGN infections were observed in patients with predisposing factors. Acinetobacter baumannii was the main etiologic agent. Mortality was high and related to prematurity and a low birth weight.


Subject(s)
Humans , Male , Female , Infant, Newborn , Gram-Negative Bacterial Infections/metabolism , Gram-Negative Bacterial Infections/drug therapy , Gram-Negative Bacterial Infections/epidemiology , Epidemiology, Descriptive , Retrospective Studies , Drug Resistance, Multiple, Bacterial , Gram-Negative Bacteria/metabolism
5.
Rev. bras. cir. cardiovasc ; 32(6): 468-474, Nov.-Dec. 2017. tab, graf
Article in English | LILACS | ID: biblio-897962

ABSTRACT

Abstract Introduction: Extracorporeal membrane oxygenation (ECMO) has become a standard technique over the past few decades in intensive care unit (ICU). Objective: A review of pediatric patients who received ECMO support in the pediatric cardiac ICU was conducted to determine the incidence, risk factors and causal organisms related to acquired infections and assess the survival rates of ECMO patients with nosocomial infections. Methods: Sixty-six patients who received ECMO support in the pediatric cardiac ICU between January 2011 and June 2014 were included in the study. Demographic, echocardiographic, hemodynamic features and surgical procedures were reviewed. Results: Sixty-six patients received a total of 292.5 days of venoarterial ECMO support. Sixty were postoperative patients. Forty-five patients were weaned from ECMO support with an ECMO survival rate of 68.2%. The rate of infection was 116.2/1000 ECMO days. Prolonged ICU stay, duration of ventilation and ECMO were found associated with development of nosocomial infection and only the duration of ECMO was an independent risk factor for nosocomial infections in ECMO patients. Conclusion: The correction of the underlying process leading to ECMO support and shortening the length of ECMO duration together with stricter application of ECMO indications would improve the infection incidence and hospital surveillance of the patient group.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Extracorporeal Membrane Oxygenation/adverse effects , Cross Infection/etiology , Extracorporeal Membrane Oxygenation/mortality , Extracorporeal Membrane Oxygenation/statistics & numerical data , Intensive Care Units, Pediatric , Cross Infection/microbiology , Cross Infection/prevention & control , Cross Infection/epidemiology , Epidemiologic Methods , Gram-Negative Bacterial Infections/classification , Gram-Negative Bacterial Infections/microbiology , Gram-Negative Bacterial Infections/prevention & control , Gram-Negative Bacterial Infections/epidemiology , Gram-Negative Bacteria/isolation & purification
6.
Acta paul. enferm ; 28(3): 281-286, May-Jun/2015. tab
Article in Portuguese | LILACS, BDENF | ID: lil-751307

ABSTRACT

Objective:To identify the prevalence of gram-positive bacteria in patients with HIV and who are hospitalized in specialized services.Methods:The present cross-sectional study approached 365 patients admitted in two specialized units of a teaching hospital located in the countryside of the state of São Paulo. The population was composed of 220 subjects. Sociodemographic and clinical data were obtained by means of individual interviews and medical record analysis. Saliva and nasal secretion were collected in the first 24 hours of the hospitalization process.Results:The prevalence of gram-negative bacteria in patients with HIV reached 14.5%, regardless of the site of their isolation. Pseudomonas aeruginosa was the most frequently isolated microorganism, followed by Klebsiella pneumoniae.Conclusion:The identification level of gram-negative bacteria was higher in the saliva (11.8%) than in the nasal secretion (3.6%), thus indicating that the collection of samples in more than one site may favor the identification of colonized and/or infected individuals...


Objetivo: Identificar a prevalência de bactérias gram-negativas em portadores de HIV internados em serviço especializado. Métodos: Trata-se de um estudo de corte transversal, foram abordados 365 indivíduos internados em duas unidades especializadas, de um hospital escola do interior paulista, sendo a população composta por 220 sujeitos. Os dados sociodemográficos e clínicos e foram obtidos por meio de entrevista individual e consulta aos prontuários. Coletaram-se também amostras de saliva e secreção nasal nas primeiras 24 horas de internação. Resultados: A prevalência de bactérias gram-negativas em portadores de HIV foi de 14,5 % independente do sítio onde foi isolado. Pseudomonas aeruginosa foi o microorganismo mais frequentemente isolado, seguida por Klebsiella pneumoniae. Conclusão: A identificação de bactérias gram-negativas foi maior na saliva (11,8%) que na secreção nasal (3,6%), indicando que coletar amostras de mais de um sítio pode favorecer a identificação de indivíduos colonizados e ou infectados...


Subject(s)
Humans , Male , Female , Middle Aged , Young Adult , HIV , Nursing Care , Hospitals, Special , Gram-Negative Bacterial Infections/epidemiology , Inpatients , Nursing Service, Hospital , Cross-Sectional Studies
7.
Braz. j. microbiol ; 46(1): 145-147, 05/2015. tab
Article in English | LILACS | ID: lil-748238

ABSTRACT

The isolation frequency of Arcobacter species in children with diarrhea, fowls, mammals and food of avian and marine origin was established. In all the samples it was possible to isolate Arcobacter species corresponding 201 (39.4%) to A. butzleri and 24 (4.7) to A. cryaerophilus. Both species were simultaneously isolated in 19 (3.7%) being A. butzleri the most frequently isolated species.


Subject(s)
Animals , Child , Humans , Arcobacter/isolation & purification , Food Microbiology , Gram-Negative Bacterial Infections/microbiology , Gram-Negative Bacterial Infections/veterinary , Birds , Chile/epidemiology , Coinfection/epidemiology , Coinfection/microbiology , Coinfection/veterinary , Disease Reservoirs , Diarrhea/epidemiology , Diarrhea/microbiology , Diarrhea/veterinary , Gram-Negative Bacterial Infections/epidemiology , Mammals , Prevalence
8.
Rev. saúde pública ; 49: 1-7, 27/02/2015. tab, graf
Article in English | LILACS | ID: lil-742282

ABSTRACT

OBJECTIVE To evaluate if temperature and humidity influenced the etiology of bloodstream infections in a hospital from 2005 to 2010. METHODS The study had a case-referent design. Individual cases of bloodstream infections caused by specific groups or pathogens were compared with several references. In the first analysis, average temperature and humidity values for the seven days preceding collection of blood cultures were compared with an overall “seven-days moving average” for the study period. The second analysis included only patients with bloodstream infections. Several logistic regression models were used to compare different pathogens and groups with respect to the immediate weather parameters, adjusting for demographics, time, and unit of admission. RESULTS Higher temperatures and humidity were related to the recovery of bacteria as a whole (versus fungi) and of gram-negative bacilli. In the multivariable models, temperature was positively associated with the recovery of gram-negative bacilli (OR = 1.14; 95%CI 1.10;1.19) or Acinetobacter baumannii (OR = 1.26; 95%CI 1.16;1.37), even after adjustment for demographic and admission data. An inverse association was identified for humidity. CONCLUSIONS The study documented the impact of temperature and humidity on the incidence and etiology of bloodstream infections. The results correspond with those from ecological studies, indicating a higher incidence of gram-negative bacilli during warm seasons. These findings should guide policies directed at preventing and controlling healthcare-associated infections. .


OBJETIVO Avaliar se temperatura e umidade influenciam a etiologia das infecções na corrente sanguínea em hospital, no período de 2005 a 2010. MÉTODOS O estudo teve delineamento caso-referência. Casos individuais de infecções de corrente sanguínea por patógenos ou grupos de interesse foram comparados com diferentes referências. Na primeira etapa, valores médios de temperatura e umidade, para os sete dias que precederam a coleta de culturas de sangue, foram comparados com a “média-móvel de ordem 7” para todos os dias do período do estudo. A segunda etapa incluiu somente os casos com culturas positivas. Foram realizadas análises por regressão logística para avaliar a influência dos parâmetros meteorológicos imediatos sobre a etiologia dessas infecções, ajustando os resultados para dados demográficos, tempo e unidade de internação. RESULTADOS Temperatura e umidade mais elevadas foram associadas às infecções de corrente sanguínea causadas por bactérias como um todo (versus fungos) e por bacilos Gram-negativos. Nos modelos multivariados, a temperatura foi positivamente associada com o isolamento nas culturas de bacilos Gram-negativos (OR = 1,14; IC95% 1,10;1,19) ou A. baumannii (OR = 1,26; IC95% 1,16;1,37), mesmo após ajuste para dados demográficos e de internação. Associação inversa foi identificada por umidade. CONCLUSÕES O estudo documentou o impacto de temperatura e umidade sobre incidência e etiologia de infecções da corrente sanguínea. Os resultados são coerentes com os relatados em estudos ecológicos, apontando para maior incidência de bacilos Gram-negativos durante as estações quentes. Esses achados devem orientar as estratégias direcionadas à prevenção e controle de infecções relacionadas à assistência à saúde. .


Subject(s)
Humans , Bacteremia/microbiology , Cross Infection/microbiology , Hot Temperature/adverse effects , Humidity/adverse effects , Brazil/epidemiology , Case-Control Studies , Gram-Negative Bacterial Infections/epidemiology , Gram-Positive Bacterial Infections/epidemiology , Weather
9.
Braz. j. microbiol ; 45(4): 1433-1437, Oct.-Dec. 2014. tab
Article in English | LILACS | ID: lil-741297

ABSTRACT

The bacterium Simkania negevensis is a germ associated with respiratory diseases. This study aims at estimating the prevalence of Simkania in the Jordanian population. Serum samples from 664 Jordanian males and females, aged 2 to 86 years were collected. IgG and IgM Simkania-specific antibodies were detected using an indirect immunofluorescence test. Seropositivity titers for IgG and IgM were defined as 1:8 and 1:10, respectively. The overall prevalence of IgG antibody in all examined Jordanian nationals was 58.4%. IgG seropositivity was low in children under the age of 10 years (34.2%), and increased rapidly with age and ranged between 49.4% and 72%. Simkania-specific IgM was detected in 24.8% of subjects. IgM prevalence in children under 10 years was lowest (10.5%) and increased in older ages and remained above 20%. Overall detection rates of both IgG and IgM were significantly higher in females than males (60.7% vs. 54.5% for IgG and 26.7% vs. 21.7% for IgM). These data indicate that Simkania infection is highly prevalent in Jordan. The high level of seropositivity is most likely maintained by re-infections or chronic infections. Our data may serve as a basis to elucidate the pathogenesis of Simkania in Jordan.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Antibodies, Bacterial/blood , Chlamydiales/immunology , Gram-Negative Bacterial Infections/epidemiology , Gram-Negative Bacterial Infections/microbiology , Age Factors , Immunoglobulin G/blood , Immunoglobulin M/blood , Jordan/epidemiology , Seroepidemiologic Studies
10.
Med. infant ; 21(2): 97-101, Junio 2014. ilus
Article in Spanish | LILACS | ID: biblio-911599

ABSTRACT

Ralstonia mannitolilytica junto con Ralstonia pickettii han sido asociadas con brotes hospitalarios relacionados con la contaminación de algún dispositivo o fluido. El objetivo de este trabajo fue describir un brote por R. mannitolilytica a partir de bacteriemias asociadas a catéteres implantables y semiimplantables ocurrido en un hospital pediátrico de alta complejidad y evaluar la utilidad del empleo de métodos moleculares para su investigación.Se detectó la presencia de bacilos gram negativos no fermentadores, con igual antibiotipo, en hemocultivos y retrocultivos a partir de dos pacientes que tenían catéteres implantables y estaban atendidos en una misma área del hospital. Se realizaron estudios microbiológicos de muestras de frascos de heparina, soluciones de dextrosa y soluciones antisépticas con resultado negativo. Algunos pacientes tuvieron signos y/o síntomas clínicos de bacteriemia al habilitar los catéteres para su uso. Se citaron para su estudio a todos los pacientes que habían tenido un procedimiento de apertura y cierre de catéter durante las fechas cercanas a los hallazgos en hemocultivos (N expuestos = 45). Ocurrieron 17 casos (infectados), a partir de los cuales se analizaron 23 aislamientos, en los que se pudo documentar la presencia de R. mannitolilytica (23 aislamientos). Por métodos moleculares se determinó que los aislamientos provenientes de muestras de pacientes involucrados en el brote se encontraban estrechamente relacionados y podrían representar una misma cepa o clon. Por evidencia circunstancial se consideró a la "solución heparínica de cierre" como fuente posible del brote (AU)


Both Ralstonia mannitolilytica and Ralstonia pickettii have been associated with hospital outbreaks due to device or fluid contamination. The aim of this study was to describe an implantable- or semi-implantable-catheter-related bacteremia outbreak by R. mannitolilytica in a tertiary-care hospital and to assess the usefulness of molecular analysis for the identification of the organism. Non-fermenting gram-negative bacilli, with identical antibiotypes, were detected in hemocultures of two patients with implantable catheters in the same hospital area. Microbiological studies of heparin and dextrose and antiseptic solution vials were negative. Some of the patients had clinical signs and/or symptoms of bacteremia when the catheter was prepared for use. All patients who underwent a procedure of accessing or locking the port of the catheter around the time of the positive hemoculture findings were contacted (N exposed = 45). Seventeen infections were detected, of which 23 isolates were analyzed. The presence of R. mannitolilytica was recorded in 23 isolates. Molecular analysis showed that the isolates from the samples of the patients involved in the outbreak were closely related and might represent the same strain or clone. Circumstantial evidence suggested that the heparin-lock solution may have been the source of the outbreak (AU)


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Heparin/administration & dosage , Catheters, Indwelling/adverse effects , Cross Infection , Disease Outbreaks , Bacteremia/microbiology , Bacteremia/epidemiology , Ralstonia/isolation & purification , Ralstonia/classification , Gram-Negative Bacterial Infections/microbiology , Gram-Negative Bacterial Infections/epidemiology
11.
Biomédica (Bogotá) ; 34(supl.1): 81-90, abr. 2014. ilus, graf, tab
Article in Spanish | LILACS | ID: lil-712424

ABSTRACT

Introducción. Las enzimas carbapenemasas de tipo KPC tienen gran capacidad de diseminación, son causantes de epidemias y se asocian a mayor mortalidad y estancia hospitalaria. En Colombia se han venido reportando cada vez más desde 2007, pero se desconoce la prevalencia hospitalaria. Objetivo. Estimar la prevalencia hospitalaria del gen bla KPC . Materiales y métodos. Se evaluó la presencia del gen bla KPC y su ´clonalidad´ en aislamientos de enterobacterias y Pseudomonas aeruginosa de pacientes hospitalizados. Resultados. De los 424 aislamientos evaluados durante el periodo de estudio, 273 cumplieron con criterios de elegibilidad, 31,1 % fue positivo para el gen bla KPC y, al ajustar por ´clonalidad´, la positividad fue de 12,8 %. El gen bla KPC se encontró con mayor frecuencia en Klebsiella pneumoniae seguido de P. aeruginosa y otras enterobacterias. A pesar de que la unidad de cuidados intensivos aportó el mayor número de aislamientos, no se encontró un patrón más prevalente del gen bla KPC en las ellas que en las otras salas. El aparato respiratorio fue el sitio anatómico de origen con la mayor prevalencia . No se presentó estacionalidad en la frecuencia de los aislamientos portadores del gen bla KPC. Conclusión. Este estudio reveló la alta prevalencia del gen bla KPC en diferentes microorganismos aislados en varias instituciones hospitalarias del país. La extraordinaria capacidad de propagación del gen bla KPC , las dificultades del diagnóstico y la limitada disponibilidad de antibióticos plantean la apremiante necesidad de fortalecer los sistemas de vigilancia epidemiológica y ajustar oportunamente las políticas institucionales de uso racional de antibióticos con el fin de contener su diseminación a otras instituciones de salud del país.


Introduction: KPC enzymes are carbapenemases with a great capability to disseminate and to cause epidemics. They are frequently associated with higher mortality rates and prolonged hospital stay. In Colombia, they have been progressively reported since 2007; however, its prevalence in hospitals is not known. Objective: To estimate the prevalence of bla KPC gene in hospitals. Methods and materials: The presence of bla KPC gene and its clonality were evaluated in clinical isolates of Enterobacteriacea and Pseudomonas aeruginosa in hospitalized patients. Results: Of the 424 isolates tested during the study period, 273 met eligibility criteria, and 31.1% were positive for bla KPC gene; after clonality adjustment, positivity was 12.8%. The bla KPC gene was more frequent in Klebsiella pneumonia, followed by P. aeruginosa and other Enterobacteriacea . Although intensive care units (ICU) provided the majority of the isolates, the bla KPC pattern was not more prevalent in ICUs than in other wards. The respiratory tract was the anatomic source with the highest prevalence. No seasonality was observed associated with the frequency of isolation of microorganisms carrying bla KPC gene. Conclusion: This study revealed a high prevalence of bla KPC gene in microorganisms isolated from different hospitals in Colombia. The extraordinary ability of bla KPC gene to spread, the difficulties for its diagnosis and the limited antibiotics available for its treatment pose the urgent need to strengthen epidemiological surveillance systems, and to timely adjust institutional policies for rational use of antibiotics in order to limit its dissemination to other institutions in the country.


Subject(s)
Adolescent , Adult , Aged , Child , Humans , Infant , Male , Middle Aged , Bacterial Proteins/genetics , Drug Resistance, Multiple, Bacterial/genetics , Gram-Negative Bacteria/genetics , Gram-Negative Bacterial Infections/microbiology , beta-Lactam Resistance/genetics , beta-Lactamases/genetics , Colombia , Cross-Sectional Studies , Cross Infection/epidemiology , Cross Infection/microbiology , Genes, Bacterial , Gram-Negative Bacteria/enzymology , Gram-Negative Bacteria/isolation & purification , Gram-Negative Bacterial Infections/epidemiology , Hospitals, Urban , Intensive Care Units , Phenotype , Prevalence
12.
Biomédica (Bogotá) ; 34(supl.1): 91-100, abr. 2014. graf, mapas, tab
Article in Spanish | LILACS | ID: lil-712425

ABSTRACT

Introducción. La evolución de la resistencia bacteriana constituye una amenaza para la salud pública mundial. Los sistemas de vigilancia epidemiológica han integrado técnicas de biología molecular para mejorar las estrategias de control. Objetivo. Describir los perfiles moleculares y fenotípicos de los bacilos Gram negativos en unidades de cuidados intensivos de 23 hospitales de Colombia entre 2009 y 2012. Materiales y métodos. Se diseñó un estudio descriptivo en 23 hospitales del Grupo para el Estudio de la Resistencia Nosocomial (sic.) en Colombia. Se analizaron 38.048 aislamientos usando WHONET durante el periodo descrito. Se describieron perfiles de resistencia para Escherichia coli , Klebsiella pneumoniae , Pseudomonas aeruginosa y Acinetobacter baumannii. En 1.248 cepas se realizó reacción en cadena de la polimerasa (PCR) para detectar las carbapenemasas clínicamente más relevantes. Resultados. Escherichia coli fue el microorganismo más frecuente (promedio=14,8 %); la frecuencia de aislamientos de K. pneumoniae aumentó de 11 % en 2009 a 15 % en 2012 (p<0,001). La tendencia de los perfiles de multirresistencia aumentó en todas las especies estudiadas. De los aislamientos de K. pneumoniae evaluados, 68,4 % fue positivo para KPC ( Klebsiella pneumoniae Carbapenemase ), mientras que la VIM ( Verona Integron-encoded Metallo-betalactamase ) en P. aeruginosa se observó en 46,5 %. Conclusiones. Se observó un incremento en la tendencia de los microorganismos hacia la multirresistencia y una amplia distribución de las carbapenemasas. La articulación de la biología molecular con los sistemas de vigilancia permitió integrar el análisis del fenotipo con los mecanismos de resistencia involucrados en las bacterias estudiadas. Este análisis permitirá la elaboración de guías para el uso adecuado de antimicrobianos y contribuirá a la contención de estas bacterias multirresistentes en Colombia.


Introduction: The continuous evolution of antimicrobial resistance poses a major threat to public health worldwide. Molecular biology techniques have been integrated to epidemiological surveillance systems to improve the control strategies of this phenomenon. Objective: To describe the phenotypic and molecular profiles of the most important Gram negative bacilli from intensive care units in 23 Colombian hospitals during the study period 2009-2012. Materials and methods: A descriptive study was conducted in 23 hospitals belonging to the Colombian Nosocomial Resistance Study Group. A total of 38.048 bacterial isolates were analyzed using WHONET over a four-year period. The antimicrobial resistant profiles were described for Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii . Polymerase chain reaction was performed in 1.248 strains to detect the most clinically relevant carbapenemases. Results: Escherichia coli was the most frequently isolated organism (mean=14.8%). Frequency of K. pneumoniae increased significantly from 11% in 2009 to 15% in 2012 (p<0.001). All screened isolates had rising trends of multidrug-resistant profiles. KPC ( Klebsiella pneumoniae carbapenemase) was detected in 68.4% of K. pneumoniae isolates while VIM (Verona integron-encoded metallo-betalactamase) was present in 46.5% of them. Conclusion: In this study, an increase in the trend of multidrug-resistant organisms and a wide distribution of carbapenemases was observed. The integration of molecular biology to surveillance systems allowed the compilation of this data, which will aid in the construction of guidelines on antimicrobial stewardship for prevention in Colombia.


Subject(s)
Adult , Child , Child, Preschool , Humans , Infant , Infant, Newborn , Drug Resistance, Multiple, Bacterial , Gram-Negative Bacteria/drug effects , Gram-Negative Bacterial Infections/microbiology , Intensive Care Units/statistics & numerical data , Acinetobacter baumannii/drug effects , Acinetobacter baumannii/enzymology , Acinetobacter baumannii/isolation & purification , Bacterial Proteins/genetics , Carbapenems/pharmacology , Colombia/epidemiology , Escherichia coli/drug effects , Escherichia coli/enzymology , Escherichia coli/isolation & purification , Gram-Negative Bacteria/enzymology , Gram-Negative Bacteria/isolation & purification , Gram-Negative Bacterial Infections/epidemiology , Klebsiella pneumoniae/drug effects , Klebsiella pneumoniae/enzymology , Klebsiella pneumoniae/isolation & purification , Population Surveillance/methods , Pseudomonas aeruginosa/drug effects , Pseudomonas aeruginosa/enzymology , Pseudomonas aeruginosa/isolation & purification , beta-Lactamases/genetics
13.
Rev. chil. pediatr ; 84(5): 513-521, oct. 2013. tab
Article in Spanish | LILACS | ID: lil-698672

ABSTRACT

Introducción: La sepsis y meningitis son importante causa de morbi-mortalidad neonatal. Objetivo: Identificar la prevalencia y riesgo de meningitis en neonatos con sepsis por Streptococcus del grupo B (SGB) y bacterias Gram negativas (BGN), además de comparar factores de riesgo, características clínicas y de laboratorio. Pacientes y Método: Estudio de corte transversal con 30 neonatos con SGB y 41 con BGN. Los datos fueron analizados en Stata® 11.0, empleando medidas de tendencia central y dispersión de acuerdo a su distribución para comparar diferencias. Las variables categóricas fueron comparadas con prueba de χ2 o Exacta de Fisher y las asociaciones mediante razones de prevalencia (RP) y odds ratio (OR) con su intervalo de confianza de 95 por ciento. Se empleó un nivel de probabilidad < 0,05 como criterio de significancia. Resultados: La prevalencia de meningitis entre neonatos con sepsis fue 16,9 por ciento (IC 95 por ciento: 7,5-26,3 por ciento). El 33,3 por ciento (10/30) de sepsis por SGB se asoció a meningitis, mientras 4,9 por ciento (2/40) a sepsis por BGN, hallándose una asociación entre sepsis y meningitis en neonatos con SGB (OR: 9,5; IC 95 por ciento: 1,7-94,3). El 80 por ciento (IC 95 por ciento: 44,4-97,5 por ciento) de casos de meningitis asociada a sepsis por SGB ocurrió en neonatos mayores de 72 h de vida. Conclusión: La meningitis fue más frecuente en neonatos con sepsis por SGB, principalmente en casos de sepsis tardía. La asociación entre sepsis por BGN y meningitis fue menos frecuente en sepsis temprana, y no se halló en sepsis tardía.


Introduction: Sepsis and meningitis are major causes of neonatal morbidity and mortality. Objective: To identify the prevalence and risk of meningitis in neonates with sepsis due to group B Streptococcus (GBS) and gram-negative bacteria (GNB), and to compare risk factors, clinical and laboratory characteristics. Patients and Method: Cross-sectional study of 30 infants with infections due to GBS and 41 due to BGN. Data were analyzed by Stata® 11.0, using measures of central tendency and dispersion, according to their distribution, to compare differences. Categorical variables were compared using χ2 test or Fisher's Exact Test and associations using prevalence ratios (PR) and odds ratio (OR) with 95 percent confidence interval. A level of probability of < 0.05 was used as a significance criterion. Results: The prevalence of meningitis among infants with sepsis was 16.9 percent (95 percent CI: 7.5-26.3 percent. 33.3 percent(10/30) of sepsis due to GBS was associated with meningitis, while 4.9 percent (2/40) was associated with GNB, finding a clear connection between sepsis and meningitis in neonates with GBS (OR: 9.5; CI 95 percent:1.7-94.3). 80 percent (CI 95 percent: 44,4-97,5 percent) of cases of meningitis associated with GBS sepsis occurred in infants older than 72 hours. Conclusion: Meningitis was more common in infants with GBS sepsis, mainly in cases of late-onset sepsis. The association between GNB sepsis and meningitis was less frequent in early sepsis, and was not found in late sepsis.


Subject(s)
Humans , Male , Female , Infant, Newborn , Streptococcal Infections/epidemiology , Gram-Negative Bacterial Infections/epidemiology , Meningitis, Bacterial/epidemiology , Sepsis/epidemiology , Gram-Negative Bacteria/isolation & purification , Colombia , Cross-Sectional Studies , Prevalence , Risk Factors , Sepsis/microbiology , Streptococcus agalactiae/isolation & purification
14.
Braz. j. infect. dis ; 17(4): 450-454, July-Aug. 2013. tab
Article in English | LILACS | ID: lil-683133

ABSTRACT

OBJECTIVE: We report an outbreak of Achromobacter xylosoxidans at a neonatal intensive care unit. We aimed to present clinical, laboratory and treatment data of the patients. Materials and METHODS: All consecutive episodes of bacteremia due to A. xylosoxidans at our neonatal intensive care unit, beginning with the index case detected at November 2009 until cessation of the outbreak in April 2010, were evaluated retrospectively. RESULTS: Thirty-four episodes of bacteremia occurred in 22 neonates during a 6-month period. Among the affected, 90% were preterm newborns with gestational age of 32 weeks or less and 60% had birth weight of 1000 g or less. Endotracheal intubation, intravenous catheter use, total parenteral nutrition and prolonged antibiotic therapy were the predisposing conditions. Presenting features were abdominal distention, thrombocytopenia and neutropenia. The mortality rate was 13.6% and the majority of isolates were susceptible to piperacillin-tazobactam, carbapenems and trimethoprim-sulfametoxazole, and resistant to gentamycin. More than half were breakthrough infections. Despite intensive efforts to control the outbreak by standard methods of hand hygiene, patient screening and isolation, containment could be achieved only after the neonatal intensive care unit was relocated. The investigation was not able to single out the source of the outbreak. CONCLUSION: A. xylosoxidans has the potential to cause serious infections in premature babies. More studies are needed to determine the importance of different sources of infection in hospital units.


Subject(s)
Female , Humans , Infant, Newborn , Male , Achromobacter denitrificans , Bacteremia/microbiology , Cross Infection/microbiology , Gram-Negative Bacterial Infections/microbiology , Achromobacter denitrificans/drug effects , Achromobacter denitrificans/isolation & purification , Bacteremia/drug therapy , Bacteremia/epidemiology , Cross Infection/drug therapy , Cross Infection/epidemiology , Disease Outbreaks , Gram-Negative Bacterial Infections/drug therapy , Gram-Negative Bacterial Infections/epidemiology , Intensive Care Units, Neonatal , Retrospective Studies , Turkey
15.
Rev. argent. microbiol ; 45(1): 44-9, mar. 2013.
Article in Spanish | LILACS, BINACIS | ID: biblio-1171769

ABSTRACT

The bacterial isolates from respiratory samples of 50 pediatric patients with cystic fibrosis, their distribution by ages and antimicrobial resistance pattern as well as the intermittence of isolations and coinfections, were investigated. Staphylococcus aureus was isolated in 72


of patients, followed by Pseudomonas aeruginosa (58


), and the Burkholderia cepacia complex (12


). The frequency of resistance of P. aeruginosa isolates to ß-lactam antibiotics was low (13.8


). Fifty percent of S. aureus isolates was methicillin-resistant, and 57.1


of H. influenza was ampicillin resistant due to ß-lactamase production. In children under 4 years-old, S. aureus was predominant, followed by P. aeruginosa and H. influenzae. This order of predominance was observed in all the groups studied, except in that of children between 10 and 14 years-old. Stenotrophomonas maltophilia and Achromobacter xylosoxidans isolates were intermittent and accompanied by other microorganisms. Finally, we observed a great variety of bacterial species, which imposes stringent performance requirements for microbiological studies in all respiratory samples of these patients.


Subject(s)
Gram-Negative Bacteria/isolation & purification , Cystic Fibrosis/complications , Respiratory Tract Infections/microbiology , Respiratory System/microbiology , Staphylococcus aureus/isolation & purification , Adolescent , Gram-Negative Bacteria/drug effects , Coinfection/epidemiology , Coinfection/microbiology , Child , Sputum/microbiology , Species Specificity , Retrospective Studies , Pharynx/microbiology , Drug Resistance, Multiple, Bacterial , Age Factors , Female , Cystic Fibrosis/microbiology , Humans , Staphylococcal Infections/epidemiology , Staphylococcal Infections/etiology , Staphylococcal Infections/microbiology , Respiratory Tract Infections/epidemiology , Respiratory Tract Infections/etiology , Gram-Negative Bacterial Infections/epidemiology , Gram-Negative Bacterial Infections/etiology , Gram-Negative Bacterial Infections/microbiology , Infant , Male , Nasopharynx/microbiology , Child, Preschool
16.
Rev. Inst. Med. Trop. Säo Paulo ; 54(6): 299-304, Nov.-Dec. 2012. ilus, tab
Article in English | LILACS | ID: lil-656262

ABSTRACT

This work aimed to assess pathogenic potential and clonal relatedness of Aeromonas sp. and Vibrio cholerae isolates recovered during a diarrhea outbreak in Brazil. Clinical and environmental isolates were investigated for the presence of known pathogenic genes and clonal relatedness was assessed by intergenic spacer region (ISR) 16S-23S amplification. Four Aeromonas genes (lip, exu, gcat, flaA/B) were found at high overall frequency in both clinical and environmental isolates although the lip gene was specifically absent from selected species. A fifth gene, aerA, was rarely found in A. caviae, the most abundant species. The ISR profile revealed high heterogeneity among the Aeromonas isolates and no correlation with species identification. In contrast, in all the V. cholerae isolates the four genes investigated (ctxA, tcpA, zot and ace) were amplified and revealed homogeneous ISR and RAPD profiles. Although Aeromonas isolates were the major enteric pathogen recovered, their ISR profiles are not compatible with a unique cause for the diarrhea events, while the clonal relationship clearly implicates V. cholerae in those cases from which it was isolated. These results reinforce the need for a better definition of the role of aeromonads in diarrhea and whether they benefit from co-infection with V. cholerae.


O objetivo deste trabalho foi estabelecer o potencial patogênico e a relação clonal de isolados de Aeromonas sp. e Vibrio cholerae obtidos durante um surto de diarréia. Isolados clínicos e ambientais foram investigados quanto à presença de genes de virulência e sua relação clonal foi obtida através de amplificação da Região Espaçadora Intergênica (REI) 16S-23S. Quatro genes de Aeromonas (lip, exu, gcat, flaA/B) foram encontrados em alta frequência embora o gene lip tenha se mostrado ausente em algumas espécies. Um quinto gene, aerA, foi raramente encontrado em A. caviae, a espécie mais abundante. O perfil da REI revelou alta heterogeneidade entre os isolados de Aeromonas e nenhuma correlação com espécie. Em contraste, todas as amostras de V. cholerae amplificaram os genes investigados (ctxA, tcpA, zot e ace) e revelaram perfil clonal através de REI e RAPD. Embora Aeromonas tenha sido o principal patógeno isolado, o perfil da REI não é compatível como única causa para os eventos de diarréia, enquanto a relação clonal de V. cholerae aponta esse microrganismo como o provável agente do surto. Estes resultados reforçam a necessidade de definir melhor o papel de Aeromonas em diarréias e de que forma essas bactérias se beneficiam quando em co-infecção com V. cholerae.


Subject(s)
Humans , Aeromonas/genetics , Coinfection/microbiology , Disease Outbreaks , Diarrhea/microbiology , Gram-Negative Bacterial Infections/microbiology , Vibrio cholerae O1/genetics , Aeromonas/pathogenicity , Brazil/epidemiology , Coinfection/epidemiology , DNA, Bacterial/genetics , Diarrhea/epidemiology , Genotype , Gram-Negative Bacterial Infections/epidemiology , Polymerase Chain Reaction , Random Amplified Polymorphic DNA Technique , Vibrio cholerae O1/pathogenicity , Virulence/genetics
17.
Indian J Med Microbiol ; 2012 Oct-Dec; 30(4): 448-452
Article in English | IMSEAR | ID: sea-144008

ABSTRACT

Purpose: To evaluate the outcomes of the patients who were infected with colistin-only-susceptible (COS) Acinetobacter baumannii and treated with either colistin monotherapy or colistin combined therapy. Materials and Methods: This retrospective case-control study was conducted in the training and research hospital with an 800 beds between August 2008 and December 2011. The patients, who were infected with COS A. baumannii and received either colistin monotherapy or colistin combined therapy, were included into the study. Results: In total, 51 patients fulfilling study criteria were evaluated. Colistin monotherapy was found effective as much as colistin combined therapy in terms of clinical and microbiological responses in patients with ventilator associated pneumonia (VAP) and also in patients with blood stream infections. Conclusion: Although there is no randomised controlled study yet, colistin monotherapy and colistin combined therapy are likely to achieve similar treatment responses rates. Heteroresistant strains can emerge in patients who receive colistin monotherapy.


Subject(s)
Acinetobacter baumannii/drug effects , Acinetobacter baumannii/pathogenicity , Anti-Bacterial Agents/pharmacology , Colistin/administration & dosage , Colistin/pharmacokinetics , Colistin/therapeutic use , Drug Therapy, Combination , Drug Resistance, Bacterial , Gram-Negative Bacterial Infections/drug therapy , Gram-Negative Bacterial Infections/epidemiology , Humans , Patients , Pneumonia, Ventilator-Associated/drug therapy , Pneumonia, Ventilator-Associated/microbiology
18.
Rev. chil. infectol ; 29(4): 449-452, ago. 2012. ilus, tab
Article in Spanish | LILACS | ID: lil-649831

ABSTRACT

Introduction: Human intestinal spirochetosis (HIE) is defined as colonization by spirochetes of the large intestine. Is associated with chronic diarrhea. The incidence and prevalence ranges from 0.4% to 12%. Objective: To determine the prevalence of HIE in the Salvador's Hospital, between 2003 and 2008 in patients with a history of chronic diarrhea and without abnormalities in colonoscopy, in 2 separate groups: patients with and without a history of HIV infection. Material and Methods: Retrospective morphology evaluation of the large bowel endoscopic biopsies to the selected groups. Results: We reviewed 115 biopsies, 98 were from HIV-negative and 17 HIV from positive patients. Two cases of intestinal spirochetosis were detected, both HIV negative, with a prevalence of 1.7%. Comment: The prevalence of HIE is similar to that reported in Western countries. Population studies are needed to determine the real epidemiological impact in our environment.


Introducción: La espiroquetosis intestinal humana (EIH) se define como la colonización del intestino grueso por espiroquetas. Se asocia a diarrea crónica. Su incidencia y prevalencia van desde 0,4 a 12% Objetivo: Determinar la prevalencia de EIH en el Hospital Del Salvador, de Santiago, Chile, entre los años 2003 y 2008, en pacientes con antecedentes clínicos de diarrea crónica y colonoscopia sin hallazgos patológicos, separados en dos grupos: pacientes con y sin antecedentes de infección por VIH. Material y Método: Evaluación morfológica retrospectiva de las biopsias endoscópicas de intestino grueso de los grupos seleccionados. Resultados: Se revisaron 115 biopsias, 98 correspondieron a pacientes sin infección por VIH y 17 a pacientes seropositivos para VIH. Se detectaron dos casos de espiroquetosis intestinal, ambos en pacientes sin infección por VIH, con una prevalencia de 1,7 %. Comentario: La prevalencia de EIH es similar a la publicada en países occidentales. Se requieren estudios poblacionales para determinar el real impacto epidemiológico en nuestro medio.


Subject(s)
Aged , Female , Humans , Male , Middle Aged , Brachyspira , Gram-Negative Bacterial Infections/epidemiology , Intestinal Diseases/epidemiology , Chronic Disease , Chile/epidemiology , Diarrhea/microbiology , Gentian Violet , Gram-Negative Bacterial Infections/complications , HIV Infections/complications , Intestinal Diseases/microbiology , Phenazines , Prevalence
19.
Article in Spanish | LILACS | ID: lil-612943

ABSTRACT

Antibacterial drug resistance is a particularly significant issue in Latin America. This article explores antimicrobial resistance in three classes of clinically important bacteria: gram-positive bacteria, enterobacteria, and nonfermenting gram-negativebacilli. The gram-positive bacteria frequently responsible for infections in humans are for the most part cocci: staphylococci, streptococci (including pneumococci), and enterococci,in both community and hospital settings. This situation is no different in theRegion of the Americas. Among the gram-positive bacteria, the causative agents of bacteremia are most commonly strains of coagulase-negative Staphylococcus, followed by enterococci. This report explores the resistance of these species to different antimicrobial drugs, resistance mechanisms in community and hospital strains, and new drugs for treating infections caused by these bacteria. In Latin America, antimicrobialresistance in Enterococcus strains is still a minor problem compared to the situation in the United States. The strains of the genus Streptococcus isolated from respiratory infections are still sensitive to penicillin. Furthermore, the resistance of enterobacteriais extremely important in the Region, particularly because of the broad dissemination of CTX-M extended-spectrum beta-lactamases (ESBL), some of which originated in Latin America. This article analyzes the resistance of Streptococcus pneumoniae, betahemolytic streptococci, and viridans group streptococci. Among the nonfermentinggram-negative bacilli, while Pseudomonas aeruginosa strains remain the leading cause of bacteremia, infections caused by strains of Acinetobacter spp. have proliferatedextensively in some areas. With regard to antibiotics, several options are available for treating gram-positive bacterial infections...


La resistencia a los fármacos antibacterianos tiene particular importancia en América Latina. En este artículo se analiza la resistencia a los antimicrobianos de tres clases de bacterias de importancia clínica: bacterias grampositivas, enterobacterias y bacilos gramnegativos no fermentadores.Las bacterias grampositivas que producen infecciones humanas frecuentes son, en su mayoría, cocos: estafilococos, estreptococos (incluidos neumococos) y enterococos, tanto en elmedio comunitario como en el nosocomial. Esta situación no es diferente en la Región de las Américas. Entre las bacterias grampositivas, las que causan bacteriemia con mayor frecuencia corresponden a cepas de estafilococos coagulasa negativos, seguidas de las de enterococos. Eneste informe se analiza la resistencia de estas especies a distintos antimicrobianos, los mecanismosde resistencia para las cepas de origen hospitalario y comunitario y los nuevos medicamentos para tratar las infecciones por estas bacterias. La resistencia a los antimicrobianos delas cepas de Enterococcus en América Latina todavía es un problema menor en relación con la situación en los Estados Unidos de América. Las cepas del género Streptococcus aisladasde infecciones respiratorias aún son sensibles a penicilina. Por otra parte, la resistencia de las enterobacterias es de gran importancia en la Región, particularmente por la gran difusión debetalactamasas de espectro extendido (BLEE) de tipo CTX-M, algunas de las cuales se originaron en América Latina. En el presente artículo se analizan la situación de la resistencia de las cepas de Streptococcus pneumoniae, y de los estreptococos betahemolítico y del grupo viridans. Entre los bacilos gramnegativos no fermentadores, si bien las cepas de Pseudomonasaeruginosa siguen siendo la causa principal de bacteriemias, la proliferación de infecciones por cepas de Acinetobacter spp. tiene en algunas partes gran magnitud...


Subject(s)
Humans , Drug Resistance, Microbial , Drug Resistance, Multiple, Bacterial , Infection Control , Acinetobacter Infections/drug therapy , Acinetobacter Infections/epidemiology , Acinetobacter/drug effects , Acinetobacter/enzymology , Acinetobacter/genetics , Anti-Bacterial Agents/classification , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Biofilms , Bacterial Proteins/genetics , Bacterial Proteins/physiology , Developing Countries , Drug Resistance, Microbial/genetics , Drug Resistance, Multiple, Bacterial/genetics , Enterobacteriaceae Infections/drug therapy , Enterobacteriaceae Infections/epidemiology , Enterobacteriaceae/drug effects , Enterobacteriaceae/genetics , Enterococcus/drug effects , Enterococcus/genetics , Global Health , Gram-Negative Bacterial Infections/drug therapy , Gram-Negative Bacterial Infections/epidemiology , Gram-Negative Bacterial Infections/microbiology , Gram-Positive Bacteria/drug effects , Gram-Positive Bacteria/genetics , Gram-Positive Bacterial Infections/drug therapy , Gram-Positive Bacterial Infections/epidemiology , Gram-Positive Bacterial Infections/microbiology , Latin America , Methicillin-Resistant Staphylococcus aureus/drug effects , Methicillin-Resistant Staphylococcus aureus/genetics , Pseudomonas Infections/drug therapy , Streptococcus/drug effects , Streptococcus/genetics , beta-Lactamases/genetics , beta-Lactamases/physiology
20.
Rev. panam. salud pública ; 30(6): 603-609, Dec. 2011.
Article in English | LILACS | ID: lil-612957

ABSTRACT

Objective. To determine whether restricting the use of ceftriaxone and ciprofloxacin could significantly reduce colonization and infection with resistant Gram-negative bacilli (r-GNB). Methods. A two-phase prospective study (before/after design) was conducted in an intensive care unit in two time periods (2004–2006). During phase 1, there was no antibiotic restriction. During phase 2, use of ceftriaxone or ciprofloxacin was restricted. Results. A total of 200 patients were prospectively evaluated. In phase 2, the use of ceftriaxone was reduced by 93.6% (P = 0.0001) and that of ciprofloxacin by 65.1% (P = 0.041), accompanied by a 113.8% increase in use of ampicillin-sulbactam (P = 0.002). During phase 1, 48 GNB were isolated [37 r-GNB (77.1%) and 11 non-r-GNB (22.9%)], compared with a total of 64 during phase 2 [27 r-GNB (42.2%) and 37 non-r-GNB (57.8%)] (P = 0.0002). Acinetobacter spp. was isolated 13 times during phase 1 and 3 times in phase 2 (P = 0.0018). The susceptibility of Pseudomonas aeruginosa to ciprofloxacin increased from 40.0% in phase 1 to 100.0% in phase 2 (P = 0.0108). Conclusions. Restriction of ceftriaxone and ciprofloxacin reduced colonization byAcinetobacter spp. and improved the susceptibility profile of P. aeruginosa.


Objetivo. Determinar si la restricción del uso de ceftriaxona y ciprofloxacino reduce significativamente la colonización y la infección por bacilos gramnegativos resistentes. Métodos. Se efectuó un estudio prospectivo de dos fases (diseño antes/después de la intervención) en una unidad de cuidados intensivos en dos períodos sucesivos entre los años 2004 y 2006. Durante la fase 1, no hubo ninguna restricción de antibióticos. Durante la fase 2, se restringió el uso de ceftriaxona y ciprofloxacino. Resultados. Se evaluó prospectivamente a 200 pacientes en total. En la fase 2, el uso de ceftriaxona se redujo en 93,6% (P = 0,0001) y el de ciprofloxacino en 65,1% (P = 0,041), lo que se acompañó de un aumento de 113,8% en el uso de ampicilina/sulbactam (P = 0,002). Durante la fase 1, se aislaron 48 bacilos gramnegativos (37 resistentes [77,1%] y 11 no resistentes [22,9%]), en comparación con un total de 64 durante la fase 2 (27 resistentes [42,2%] y 37 no resistentes [57,8%]) (P = 0,0002). Se aisló Acinetobacter spp. 13 veces durante la fase 1 y 3 veces en la fase 2 (P = 0,0018). La sensibilidad de Pseudomonas aeruginosa al ciprofloxacino aumentó de 40,0% en la fase 1 a 100,0% en la fase 2 (P = 0,0108). Conclusiones. La restricción del uso de ceftriaxona y ciprofloxacino redujo la colonización por Acinetobacter spp. y mejoró el perfil de sensibilidad de P. aeruginosa.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Acinetobacter Infections/prevention & control , Acinetobacter baumannii/isolation & purification , Ceftriaxone/therapeutic use , Ciprofloxacin/therapeutic use , Cross Infection/microbiology , Drug Resistance, Microbial , Intensive Care Units/statistics & numerical data , Pseudomonas Infections/prevention & control , Pseudomonas aeruginosa/drug effects , Acinetobacter Infections/epidemiology , Acinetobacter Infections/microbiology , Cross Infection/epidemiology , Diagnosis-Related Groups , Drug and Narcotic Control , Drug Resistance, Multiple, Bacterial , Drug Prescriptions/statistics & numerical data , Gram-Negative Bacteria/drug effects , Gram-Negative Bacteria/isolation & purification , Gram-Negative Bacterial Infections/epidemiology , Gram-Negative Bacterial Infections/microbiology , Hospitals, Public/statistics & numerical data , Hospitals, University/statistics & numerical data , Incidence , Prospective Studies , Pseudomonas Infections/epidemiology , Pseudomonas Infections/microbiology , Pseudomonas aeruginosa/isolation & purification , Superinfection , Uruguay/epidemiology
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