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1.
Infectio ; 25(3): 193-196, jul.-set. 2021. tab, ilus
Article in Spanish | LILACS, COLNAL | ID: biblio-1250092

ABSTRACT

Resumen El constante aumento de Enterobacterales productores de carbapenemasas (CPE) se constituye en un problema de salud pública a nivel mundial, por el impacto generado en la mortalidad de los pacientes. El tracto gastrointestinal es el principal reservorio de este tipo de microorganismos, por lo cual, la colonización rectal se convierte en un importante factor de riesgo para el desarrollo de posteriores infecciones. Una de las estrategias de vigilancia epidemiológica activa, es la búsqueda de pacientes colonizados, a través de cultivos de tamización para detectar estos microrganismos multirresistentes. Reportamos el caso de un paciente, con historia de sepsis de origen pulmonar, colonizado por Klebsiella pneumoniae con coproducción de carbapenemasas NDM + KPC y Escherichia coli con carbapenemasa NDM. Este hallazgo es cada vez más frecuente, lo cual implica un reto en su detección y diagnóstico. Se describen características del paciente, procedimientos realizados y hallazgos microbiológicos.


Abstract The constant increase in carbapenemase-producing Enterobacterales (CPE) constitutes a public health problem worldwide, due to the impact generated on the mortality of patients. The gastrointestinal tract is the main reservoir for this microorganism, which is why, rectal colonization becomes an important risk factor for the development of subsequent infections. One of the active epidemiological surveillance strategies is the search for colonized patients through screening cultures, to detect these multi-resistant microorganisms. We report the case of a patient, with a history of sepsis of pulmonary origin, colonized by Klebsiella pneumoniae with co-production of NDM + KPC carbapenemases and NDM carbapenemase-producing Escherichia coli. This finding is more and more frequent, which implies a challenge in its detection and diagnosis. Patient characteristics, procedures performed and microbiological findings are described.


Subject(s)
Humans , Middle Aged , Enterobacteriaceae , Carbapenem-Resistant Enterobacteriaceae , Sepsis , Gastrointestinal Tract , Escherichia coli , Infections , Klebsiella pneumoniae
2.
Medicina (Ribeirão Preto) ; 54(1)jul, 2021. tab
Article in Portuguese | LILACS | ID: biblio-1353668

ABSTRACT

RESUMO: Introdução: A cabine de segurança biológica (CBS) é um equipamento de proteção coletiva, utilizado para efe-tuar a contenção de aerossóis produzidos nos procedimentos laboratoriais. A CBS protege tanto os trabalhadores, quanto o material manipulado e o meio ambiente. Dispõe de lâmpadas de luz ultravioleta (UV) que possui ação germicida, alterando os ácidos nucleicos dos micro-organismos. Objetivo: O objetivo do presente estudo foi avaliar a ação germicida da luz UV da CBS classe II, tipo A2, frente à cultura de duas espécies de bactérias com diferentes condições de exposição a luz UV. Material e Métodos: Para o desenvolvimento da pesquisa foram utilizadas as bactérias Staphylococcus aureus ATCC 25923 e Klebsiella pneumoniae ATCC 10031, na concentração de 1,5x108 Unidades Formadoras de Colônias/ml (UFC/ml), que após a semeadura em biplacas de Petri foram expostas à luz UV em diferentes condições e tempos. Resultados: Os resultados obtidos revelaram que as espécies de bactérias apresentaram igual perfil de crescimento ou inibição quando submetidas às diferentes condições de exposição. As biplacas de Petri com as tampas abertas e protegidas ou não com embalagem de esterilização apresentaram, nos tempos 15 e 20 minutos, inibição bacteriana. Nas biplacas protegidas pelo papel alumínio e nas biplacas com a tampa fechada, independentemente do tempo e da condição, os micro-organismos apresentaram crescimento bacteriano. Conclusão: Com os resultados obtidos, sugere-se que a ação germicida da luz UV foi eficaz, garantindo a descontaminação adequada e assegurando a qualidade na biossegurança laboratoria. (AU)


ABSTRACT: Introduction: The biological safety cabinet (BSC) is a collective protective device used to hold aerosols produced in laboratory procedures. The BSC protects workers, material handling, and the environment. It relies on ultraviolet light (UV) lamps that have germicidal action, altering the nucleic acids of microorganisms. Objective: The objective of the present study was to evaluate the germicidal action of BSC class II type A2 UV light against the culture of two bacterial species with different conditions of exposure to UV light. Methods: For the research, the bacteria Sta-phylococcus aureus ATCC 25923 and Klebsiella pneumoniae ATCC 10031 were used, at a concentration of 1.5x108Colony Forming Units/ml (CFU/ml), which were seeded in Petri biplates. Use UV light under different conditions and times. Results: The bacterial species showed the same growth or inhibition profile when subjected to different exposure conditions. Petri dishes with the cover open and protected or not with sterilization packaging showed bacterial inhibition at 15 and 20 minutes. The microorganisms in the biplates protected by the aluminum foil and in the biplates with the cover on, regardless of the time and condition, showed bacterial growth. Conclusion: With the results obtained, it is suggested that the germicidal action of UV light was effective, ensuring adequate decon-tamination and ensuring quality in laboratory biosafety. (AU)


Subject(s)
PUVA Therapy , Staphylococcus aureus , Ultraviolet Rays , Bacterial Growth , Decontamination , Klebsiella pneumoniae , Anti-Infective Agents
3.
Rev. epidemiol. controle infecç ; 11(2): [1-6], abr.-jun. 2021. ilus
Article in English, Portuguese | LILACS | ID: biblio-1362912

ABSTRACT

Objetivo: Relatar o caso de uma paciente não diabética com cistite enfisematosa. Descrição do caso: A seguinte descrição foi aprovada pelo CEP da UNIPAMPA conforme parecer n° 3.459.252. Paciente feminina, 82 anos, não diabética, que havia realizado procedimento cirúrgico. Achados em exames de imagem associados à cultura e exames laboratoriais direcionaram o diagnóstico para cistite enfisematosa. Foi realizado manejo conservador com antibioticoterapia com boa evolução. Conclusão: A cistite enfisematosa é um diagnóstico diferencial que requer alto nível de suspeição em pacientes não diabéticos, sendo o uso de métodos de imagem essencial para a sua realização.(AU)


Objectives: To report the case of a non-diabetic patient with emphysematous cystitis. Case description: The following description was approved by the REC from UNIPAMPA registered under the n° 3.459.252. Non-diabetic, 82 year-old female patient, who had undergone a surgical procedure. Findings in image tests associated with culture and laboratory tests directed her diagnosis to emphysematous cystitis. Conservative management was carried out and the patient was discharged after seven days of antibiotic therapy. Conclusion: Emphysematous cystitis is a differential diagnosis that requires a high level of clinical suspicion in non-diabetic patients and the use of imaging methods is essential for its achievement.(AU)


Objetivos: Reportar el caso de una paciente no diabética con cistitis enfisematosa. Descripción del caso: La siguiente descripción fue aprobada por el CEI de la UNIPAMPA según parecer n° 3.459.252. Paciente femenina de ochenta y dos años, no diabética, que había realizado un procedimiento quirúrgico. Evidencias encontradas en los exámenes de imagen asociados a cultivos y exámenes de laboratorio direccionaron el diagnóstico a Cistitis enfisematosa. Fue realizado el manejo conservador con antibioticoterapia con buena evolución. Conclusión: Cistitis enfisematosa es un diagnóstico diferencial que requiere un alto nivel de sospecha clínica en pacientes no diabéticos, siendo el uso de métodos de imagen esencial para su realización.(AU)


Subject(s)
Humans , Female , Aged, 80 and over , Urinary Tract Infections , Cystitis , Klebsiella pneumoniae
4.
Infectio ; 25(2): 84-88, abr.-jun. 2021. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1250072

ABSTRACT

Resumen Introducción: Klebsiella pneumoniae produce enzimas como Betalactamasas de Espectro Extendido (BLEE) y Carbapenemasas. Estas enzimas tienen implicancia en las Unidades de Cuidados Intensivos (UCI), porque posibilitan la supervivencia de especies bacterianas a condiciones desfavorables y por ende, facilitan su permanencia en ambiente intrahospitalario. Existe evidencia de presencia de Klebsiella pneumoniae en UCI, en muestras procedentes de: pacientes, personal de salud, habitación, lavamanos y fórmulas nutricionales. Objetivo: Evaluar el perfil de resistencia de los aislamientos de Klebsiella pneumoniae en una UCI de Paraguay. Material y métodos: Estudio descriptivo observacional, transversal. Se recolectaron 200 muestras (124 fórmulas enterales, 40 ambiente y 36 pacientes). Variables analizadas: origen de muestra, presencia del germen, producción de enzimas y perfil de resistencia. Resultados: Se aisló Klebsiella pneumoniae en 14% de las muestras. Se identificó al germen en: 25% pacientes, 12,9% fórmulas enterales y 7,5% ambiente. Se observó producción de BLEE en 85,7% de las cepas, con perfiles de resistencia idénticos, y producción de carbapenemasas en 14,3% de las cepas, con perfiles de resistencia diferentes. Conclusión: la presencia y los perfiles de resistencia de Klebsiella pneumoniae en las tres clases de muestras estudiadas, sugieren transferencia de genes de resistencia y diseminación del germen en UCI.


Abstract Introduction: Klebsiella pneumoniae produces enzymes such as Extended Spectrum Betalactamases (ESBL) and Carbapenemases. These enzymes have implica tions in Intensive Care Units (ICU), because they enable the survival of bacterial species under unfavorable conditions and, therefore, facilitate their permanence in the hospital environment. There is evidence of the presence of Klebsiella pneumoniae in the ICU, in samples from: patients, health staff, room, sink, and nutri tional formulas. Objective: To evaluate the resistance profile of Klebsiella pneumoniae isolates in an ICU in Paraguay. Material and methods: descriptive, observational, cross-sectional study. 200 samples were collected (124 enteral formulas, 40 ambient and 36 patients). Variables analyzed: sample origin, presence of the germ, enzyme production and resistance profile. Results: Klebsiella pneumoniae was isolated in 14% of the samples. The germ was identified in: 25% patients, 12.9% enteral formulas and 7.5% environment. Pro duction of ESBL was observed in 85.7% of the strains, with identical resistance profiles, and production of carbapenemases in 14.3% of the strains, with different resistance profiles. Conclusion: the presence and resistance profiles of Klebsiella pneumoniae in the three classes of samples studied, suggest transfer of resistance genes and disse mination of the germ in ICU.


Subject(s)
Humans , Male , Female , beta-Lactamases , Intensive Care Units , Klebsiella pneumoniae , Paraguay , Drug Resistance, Microbial , Bacteremia
5.
Notas enferm. (Córdoba) ; 20(37): 47-62, jun. 2021.
Article in Spanish | LILACS, BDENF, BINACIS, UNISALUD | ID: biblio-1283234

ABSTRACT

La percepción como concepto es el proceso mediante el cual la conciencia integra los estímulos sensoriales sobre objetos, hechos o situaciones y los transforma en experiencia útil. El presente trabajo fue una investigación cualitativa de tipo fenomenológico, cuyo objetivo principal es analizar cuáles son las percepciones del enfermero en el cuidado del paciente con aislamiento de contacto infectado por Klebsiella Pneumoniae Carbapenemasa. Los participantes fueron los enfermeros del internado general y de la unidad de terapia intensiva. El análisis de datos se realizó a través de la transcripción de las entrevistas resaltando puntos fuertes y relacionándolos entre ellos para poder obtener dimensiones y características comunes. Los participantes firmaron un consentimiento informado en donde se les solicito permiso para la grabación. Los hallazgos se organizaron en 3 dimensiones: percepción emocional del enfermero que se expresa en el miedo, la incertidumbre y la necesidad de conocimiento, el apoyo entre colegas como medio para afrontar las emociones y la igualdad y comprensión a la hora de brindar cuidado al paciente aislado por Klebsiella Pneumoniae carbapenemasa. Percepción empática que se evidencia en la empatía del personal de enfermería frente al paciente con aislamiento de contacto por Klebsiella Pneumoniae carbapenemasa. Comportamiento en la relación enfermero-paciente expresa la importancia del conocimiento y evidencia como el actuar de enfermería mejora a través de la adquisición del mismo logrando mejora en la calidad de atención brindando seguridad y confianza, no solo al paciente, sino a su propio equipo. Conclusión: Los servicios de enfermería necesitan brindar un acompañamiento con orientación desde un primer momento al enfermero que brinda cuidado al paciente con aislamiento por Klebsiella Pneumoniae carbapenemasa[AU]


Summary: perception as a concept is the process by which consciousness integrates sensory stimuli on objects, events or situations and transforms them into useful experience. The present work was a qualitative phenomenological investigation, the main objective of which is to analyze the perceptions of the nurse in the care of the patient with contact isolation infected by Klebsiella Pneumoniae Carbapenemasa. The participants were the nurses from the general boarding school and the intensive care unit. The data analysis was carried out through the transcription of the interviews, highlighting strong points nd relating them to each other in order to obtain common dimensions and characteristics. The participants signed an informed consent requesting permission for the recording. The findings were organized in 3 dimensions: emotional perception of the nurse that is expressed in fear, uncertainty and the need for knowledge, support among colleagues as a means to face emotions, and equality and understanding when providing care to the patient. isolated by Klebsiella Pneumoniae carbapenemasa. Empathic perception that is evidenced in the empathy of the nursing staff towards the patient with contact isolation due to Klebsiella Pneumoniae carbapenemase. Behavior in the nurse-patient relationship expresses the importance of knowledge and evidence of how nursing actions improve through the acquisition of it, achieving an improvement in the quality of care, providing security and confidence, not only to the patient, but to their own team. Conclusion: Nursing services need to provide guidance with guidance from the first moment to the nurse who provides care to the patient with Klebsiella Pneumoniae carbapenemasa isolation[AU]


A percepção como conceito é o processo pelo qual a consciência integra estímulos sensoriais em objetos, eventos ou situações e os transforma em experiências úteis. O presente trabalho foi uma investigação qualitativa fenomenológica, cujo objetivo principal é analisar as percepções do enfermeiro no cuidado ao paciente com isolamento de contato infectado por Klebsiella Pneumoniae Carbapenemasa. Os participantes foram os enfermeiros do internato geral e da unidade de terapia intensiva. A análise dos dados foi realizada por meio da transcrição das entrevistas, destacando os pontos fortes e relacionando-os entre si a fim de obter dimensões e características comuns. Os participantes assinaram um termo de consentimento livre e esclarecido solicitando permissão para a gravação. Os achados foram organizados em 3 dimensões: percepção emocional do enfermeiro que se expressa no medo, incerteza e necessidade de conhecimento, apoio entre os colegas como forma de enfrentar as emoções e igualdade e compreensão no cuidado ao paciente. Isolado por Klebsiella Pneumoniae carbapenemasa. Percepção empática que se evidencia na empatia da equipe de enfermagem para com o paciente com isolamento de contato por Klebsiella Pneumoniae carbapenemase. O comportamento na relação enfermeiro-paciente expressa a importância do conhecimento e da evidência de como a ação de enfermagem se aprimora por meio de sua aquisição, alcançando uma melhoria na qualidade da assistência, proporcionando segurança e confiança, não só ao paciente, mas à própria equipe. Conclusão: Os serviços de enfermagem precisam fornecer orientações com orientações desde o primeiro momento ao enfermeiro que presta cuidados ao paciente com isolamento de Klebsiella Pneumoniae carbapenemasa[AU]


Subject(s)
Humans , Male , Female , Patient Isolation , Patients , Perception , Safety , Trust , Empathy , Fear , Intensive Care Units , Klebsiella pneumoniae , Nurse-Patient Relations , Nurses, Male , Uncertainty , Qualitative Research , Emotions
6.
São José dos Campos; s.n; 2021. 62 p. graf, tab.
Thesis in Portuguese | LILACS, BBO | ID: biblio-1362540

ABSTRACT

O conhecimento dos efeitos dos extratos naturais de plantas vem cada vez mais se mostrando um campo promissor. Extratos de Calendula officinalis, Capsicum annuum e Hamamelis virginiana apresentam propriedades analgésicas, anti-inflamatórias, antioxidantes e potencial antimicrobiano que deve ser aprofundado. Assim, o objetivo foi avaliar ação antimicrobiana dos extratos glicólicos em culturas planctônicas e biofilmes de cepas padrão e clínicas de Klebsiella pneumoniae e Pseudomonas aeruginosa. Foi realizado o teste de microdiluição em caldo segundo Clinical and Laboratory Standards Institute, para determinação da Concentração Inibitória Mínima (CIM) e Concentração Microbicida Mínima (CMM) dos extratos. Foram realizados biofilmes monotípicos, nos tempos de contato de 5 min e 24 h, utilizando o teste de MTT. A CIM e CMM variaram de 1,56 a 50 mg/mL para todas as cepas avaliadas. C. annuum (50 mg/mL) apresentou redução de 0,25% entre 8,60% para cepa ATCC de P. aeruginosa (5 min) e em 24 h redução de 99,89% entre 99,99%, destacando-se os extratos de C. annuum (100 mg/mL) e os de C. officinalis. C. annuum (200 mg/mL) apresentou redução de 18% de K. pneumoniae (ATCC 4352). Em 24 h houve redução de 8,86%-75,74%, para o extrato de C. annuum (100 mg/mL). Os extratos apresentaram resultados mais satisfatórios quando expostos aos tratamentos de 24 horas. As cepas clínicas K1, K2 e K3 responderam ao tratamento de C. annuum (50 e 100 mg/mL) (p>0,05%). Para cepa clínica K4, os extratos de C. annuum (50 e 100 mg/mL) e C. officinalis (12,5 mg/mL) promoveram redução de viabilidade semelhante a clorexidina 2% (p>0,05%). O extrato de C. annuum (50 e 100 mg/mL), promoveu a redução de viabilidade de P1 e P2, enquanto o extrato de C. officinalis (25 e 50 mg/mL), reduziu P1 (p>0,05%). Para as cepas P3 e P4 o extrato de 50 e 100 mg/mL de C. annuum, apresentaram resultados semelhantes a clorexidina. Conclui-se que todos os extratos apresentaram ação antimicrobiana em cultura planctônica, no entanto, o extrato de C. annuum foi o que apresentou importante ação antibiofilme (24 h) sobre cepas clínicas multirresistentes de K. pneumoniae e P. aeruginosa, podendo ser considerado um potencial agente antimicrobiano.


Empirical knowledge of natural plant extracts is increasingly proving to be a promising field. Extracts of Calendula officinalis, Capsicum annuum and Hamamelis virginiana have analgesic, anti-inflammatory, antioxidant and antimicrobial potential that should be further developed. This research objective was to evaluate the antimicrobial action of glycolic extracts in planktonic cultures and biofilms of standard and clinical strains of Klebsiella pneumoniae and Pseudomonas aeruginosa. The broth microdilution test was performed according to the Clinical and Laboratory Standards Institute, to determine the Minimum Inhibitory Concentration (MIC) and Minimum Microbicide Concentration (MMC) of the extracts. Tests were performed on monotypic biofilms, at contact times of 5 min and 24 h, using the MTT test. The MIC and CMM of the extracts ranged from 1.56 to 50 mg/mL for all strains evaluated. C. annuum (50 mg/mL) showed a reduction of 0.25% between 8.60% for the ATCC strain of P. aeruginosa (5 min) and in 24 h a reduction of 99.89% between 99.99%, highlighting extracts from C. annuum (100 mg/mL) and from C. officinalis. C. annuum (200 mg/mL) showed an 18% reduction in K. pneumoniae (ATCC 4352). In 24 h there was a reduction of 8.86% between 75.74% for the extract of C. annuum (100 mg/mL). The extracts showed more satisfactory results when exposed to 24-hour treatments. Clinical strains K1, K2 and K3 responded to the treatment of C. annuum (50 and 100 mg/mL) (p>0.05%). For clinical strain K4, extracts of C. annuum (50 and 100 mg/mL) and C. officinalis (12.5 mg/mL) promoted a reduction in viability similar to chlorhexidine 2% (p>0.05%). The extract of C. annuum (50 and 100 mg/mL), reduced the viability of P1 and P2, while the extract of C. officinalis (25 and 50 mg/mL), reduced P1 (p>0.05% ). For strains P3 and P4, the extract of 50 and 100 mg/mL of C. annuum showed similar results to chlorhexidine. It is concluded that all extracts showed antimicrobial action in planktonic cultures, however, the extract of C. annuum was the one that showed an important antibiofilm action (24 h) on multiresistant clinical strains of K. pneumoniae and P. aeruginosa and can be considered a potential antimicrobial agent


Subject(s)
Plant Extracts , Microbial Sensitivity Tests , Biofilms , Analgesics , Anti-Infective Agents , Pseudomonas aeruginosa , Capsicum , Hamamelis , Klebsiella pneumoniae
7.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 13: 757-762, jan.-dez. 2021. graf, tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1222817

ABSTRACT

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


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


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


Subject(s)
Humans , Male , Female , Infection Control/statistics & numerical data , Klebsiella pneumoniae/drug effects , Anti-Infective Agents/therapeutic use , Anti-Bacterial Agents/therapeutic use , Piperacillin/therapeutic use , Urinary Tract/microbiology , Prevalence , Risk Factors , Hospitals, Private , Tazobactam/therapeutic use
8.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 13: 17-26, jan.-dez. 2021. tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1145877

ABSTRACT

Objetivo: verificar a demanda de hemoculturas, aspirados traqueais e uroculturas realizadas no HU-UNIVASF/ EBSERH e a prevalência dos microrganismos identificados no período de janeiro a junho de 2016. Métodos: estudo retrospectivo documental com abordagem quantitativa. Resultados: o setor de microbiologia realizou 488 hemoculturas, 427 uroculturas e 197 aspirados traqueais. A positividade de hemoculturas mostrou-se entre 10,9 à 25,7%, e o percentual de contaminações variou de 6,8 à 14,0%. Os microrganismos mais prevalência nas hemoculturas foram Staphylococcus epidermidis (23,7%), Staphylococcus aureus (19,3%) e Klebisiella pneumoniae (9,6%). Nas uroculturas foram Klebisiella pneumoniae (23,1%), Candida sp. (13,5%) e Escherichia coli (12,5%). Nos aspirados traqueais foram Acinetobacter baumannii (29,2%), Pseudomonas aeruginosa (26,6%) e Staphylococcus aureus (16,2%). Conclusão: a cultura mais solicitada foi hemocultura. A bactéria mais prevalente nas hemoculturas foi Staphylococcus epidermidis, nos aspirados traqueais Acinetobacter baumannii e nas uroculturas Klebisiella pneumoniae


Objective: the study's purpose has been to verify the demand for blood cultures, tracheal aspirates and urine cultures performed at a University Hospital from the Universidade Federal do Vale do São Francisco (HU-UNIVASF/EBSERH), as well as the predominance of microorganisms identified over the period from January to June 2016. Methods: it is a retrospective documentary study with a quantitative approach. Results: the microbiology sector carried out 488 blood cultures, 427 urine cultures and 197 tracheal aspirates. The positivity of blood cultures was between 10.9 and 25.7%, and the percentage of contaminations ranged from 6.8 to 14.0%. The most prevalent microorganisms in blood cultures were Staphylococcus epidermidis (23.7%), Staphylococcus aureus (19.3%) and Klebsiella pneumoniae (9.6%). In urine cultures were Klebsiella pneumoniae (23.1%), Candida sp. (13.5%) and Escherichia coli (12.5%). In tracheal aspirates were Acinetobacter baumannii (29.2%), Pseudomonas aeruginosa (26.6%) and Staphylococcus aureus (16.2%). Conclusion: the most requested culture was blood culture. The most prevalent bacterium in blood cultures was Staphylococcus epidermidis, in tracheal aspirates was Acinetobacter baumannii, and in urine cultures was Klebsiella pneumoniae


Objetivo: el propósito del trabajo es verificar la demanda de hemocultivos, aspirados traqueales y urocultivos realizados en el Hospital Universitário de la Universidade Federal do Vale do São Francisco (HU-UNIVASF/ EBSERH) y la prevalencia de los microorganismos identificados en el período de enero a junio de 2016. Métodos: este trabajo es un estudio retrospectivo documental con abordaje cuantitativo. Resultados: el sector de microbiología realizó 488 hemocultivos, 427 urocultivos y 197 aspirados traqueales. La positividad de hemocultivos se mostró entre el 10,9 al 25,7%, y el porcentaje de contaminaciones varía de 6,8 a 14,0%. Los microorganismos más prevalentes en los hemocultivos fueron Staphylococcus epidermidis (23,7%), Staphylococcus aureus (19,3%) y Klebsiella pneumoniae (9,6%). En los urocultivos fueron Klebisiella pneumoniae (23,1%), Candida sp. (13,5%) y Escherichia coli (12,5%). En los aspirados traqueales fueron Acinetobacter baumannii (29,2%), Pseudomonas aeruginosa (26,6%) y Staphylococcus aureus (16,2%). Conclusión: la cultura más solicitada fue hemocultivo. La bacteria más prevalente en los hemocultivos fue Staphylococcus epidermidis, en los aspirados traqueales, Acinetobacter baumannii y en los urocultivos, Klebisiella pneumoniae


Subject(s)
Urine/microbiology , Cross Infection/microbiology , Cross Infection/epidemiology , Bacteriological Techniques/methods , Blood Culture , Staphylococcus aureus , Staphylococcus epidermidis , Prevalence , Acinetobacter baumannii , Escherichia coli , Hospitals, University , Klebsiella pneumoniae
9.
Rev. Soc. Bras. Med. Trop ; 54: e02622020, 2021.
Article in English | ColecionaSUS, LILACS, ColecionaSUS, SES-SP | ID: biblio-1143877

ABSTRACT

Abstract INTRODUCTION: Carbapenemase-resistant enterobacteria that produce the bla NDM gene are found worldwide. However, this is the first report of blaNDM in Klebsiella aerogenes in Brazil. METHODS: The identification of bacterial species was performed using anautomated system and confirmed by biochemical tests, 16S rRNA gene sequencing, and detection of resistance genes. RESULTS: The clinical isolate showed minimum inhibitory concentration resistance to meropenem and polymyxin B at 8mg/L and 4mg/L, respectively. Only the blaNDM gene was detected. CONCLUSIONS: The current report of the blaNDM gene in isolated MDR enterobacteria indicates that this gene can spread silently in a hospital setting.


Subject(s)
Enterobacter aerogenes/genetics , Bacterial Proteins , beta-Lactamases/genetics , Brazil , RNA, Ribosomal, 16S , Microbial Sensitivity Tests , Drug Resistance, Multiple, Bacterial/genetics , Enterobacteriaceae , Klebsiella pneumoniae/genetics , Anti-Bacterial Agents/pharmacology
10.
Article in Chinese | WPRIM | ID: wpr-921562

ABSTRACT

The biofilm formation is a dynamic process of bacterial growth,and the extracellular components can encase these microorganisms,making them more resistant to antibiotics and host immune attack.The formation of antibiotic-resistant bacterial biofilms will be a major challenge for the treatment and control of clinical infections.


Subject(s)
Anti-Bacterial Agents , Biofilms , Klebsiella pneumoniae
11.
Article in English | LILACS, VETINDEX | ID: biblio-1347991

ABSTRACT

Eosinophilic cystitis is a rare inflammatory disorder characterized by eosinophilic infiltration of entire layers of the bladder wall. The condition has been described in adults, children, and dogs. However, there are no consensus guidelines for the treatment of eosinophilic cystitis. Although human and veterinary literature reviews show some effectiveness in management with corticosteroids, antihistamines, and antibiotics, a variety of serious and frequent side effects are associated with steroid therapy. As a result, steroids are relatively contraindicated for patients with diabetes mellitus and Cushing's syndrome. A five-year-old neutered male chow-chow with controlled diabetes was referred with an 18-month history of malodorous urine, gross haematuria, and dysuria that were nonresponsive to antibiotics. The findings on general examination were unremarkable except for abdominal suprapubic discomfort. The complete blood count and biochemical profile (such as urea and creatinine) were normal except for mild peripheral eosinophilia. Although ultrasonography, bladder contrast radiography, and urine cytology findings indicated malignancy, with the presence of atypical urothelial cells, histopathology confirmed eosinophilic cystitis. Management with cyclosporine was adequate with complete remission of haematuria. This case report presents the first reported successful use of cyclosporine for the treatment of eosinophilic cystitis in a dog with diabetes.(AU)


A cistite eosinofílica é uma doença inflamatória rara caracterizada por infiltração eosinofílica de todas as camadas da parede da bexiga. Essa enfermidade já foi descrita em adultos, crianças e cães. No entanto, não há um consenso de diretrizes sobre o seu tratamento. Mesmo que as literaturas humana e veterinária mostrem alguma eficácia no manejo com corticosteroides, anti-histamínicos e antibióticos, uma variedade de efeitos colaterais graves e frequentes está associada à terapia com esteroides. Dessa forma, o uso de esteroides é relativamente contraindicado para pacientes com diabetes mellitus e síndrome de Cushing, por exemplo. Um chow-chow, macho, castrado, de cinco anos e diabético estável foi encaminhado para atendimento com histórico de urina fétida, hematúria macroscópica e disúria não responsiva a antibióticos há 18 meses. A avaliação dos parâmetros físicos estava dentro dos padrões, exceto por desconforto abdominal suprapúbico à palpação. O hemograma e o perfil bioquímico (como a ureia e a creatinina) estavam dentro da normalidade para a espécie, exceto por eosinofilia periférica leve. Embora a ultrassonografia, a radiografia contrastada da bexiga e os achados da urinálise indicassem malignidade, com a presença de células uroteliais atípicas, a histopatologia confirmou o diagnóstico definitivo de cistite eosinofílica. O manejo com ciclosporina foi satisfatório, com ausência completa da hematúria. Este relato de caso apresenta o primeiro uso documentado de ciclosporina para o tratamento de cistite eosinofílica com sucesso em um cão com diabetes.(AU)


Subject(s)
Animals , Dogs , Cyclosporine , Cystitis , Dogs , Hematuria , Enterobacter , Eosinophilia , Klebsiella pneumoniae
12.
Rev. cuba. med. trop ; 72(3): e516, sept.-dic. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1156536

ABSTRACT

Introducción: El tratamiento de las infecciones por Klebsiella pneumoniae productora de carbapenemasa tipo KPC es complicado debido a las escasas opciones terapéuticas existentes, lo cual obliga a optimizar los esquemas terapéuticos disponibles. Objetivo: Determinar la concordancia de la tarjeta AST-N272 del Sistema Vitek 2 Compact y las tiras M.I.C.ETM Evaluator con la dilución en agar para la determinación de la concentración mínima inhibitoria del meropenem en Klebsiella pneumoniae productora de carbapenemasa tipo KPC. Métodos: Se estudiaron 53 aislados de K. pneumoniae bla KPC positivas no clonales, provenientes de hisopados rectales recolectados en diferentes unidades hospitalarias de Guayaquil, Ecuador, entre enero a junio de 2016. Se determinó la concentración mínima inhibitoria de meropenem por dilución en agar (método de referencia), así como por el sistema Vitek 2 Compact (AST-N272) y las tiras M.I.C.ETM. Se determinó la CMI 50, CMI 90 y la concordancia esencial. Resultados: El rango de la CMI de meropenem de los aislados estudiados fue de 1 a ≥ 32 µg/mL, con una CMI50= 4 µg/mL y una CMI90= ≥ 32 µg/mL. El 86,79 por ciento (n= 46) de los aislados tuvo una CMI≤ 8 µg/mL. Se observó un 94,33 por ciento de concordancia esencial con las tiras M.I.C.ETM, mientras que la tarjeta AST-N272 mostró una concordancia esencial inferior al 50 por ciento. Conclusiones: Los resultados sugieren posibles implicaciones en el tratataminto del paciente, pues reduce opciones terapéuticas en contextos de difícil manejo. Además, resaltan la necesidad de la confirmación de la resistencia a carbapenémicos mediante el método de Kirby Bawer en aquellos laboratorios que tienen métodos automatizados para estudios de susceptibilidad(AU)


Introduction: The treatment for KPC carbapenemase-producing Klebsiella pneumoniae infections is complicated, due to the scant therapeutic options available, which forces us to optimize the therapies at hand. Objective: Determine the agreement between the AST-N272 card of the Vitek 2 Compact system and the M.I.C.E.TM Evaluator strips, and the agar dilution method for determination of the minimum inhibitory meropenem concentration in KPC carbapenemase-producing Klebsiella pneumoniae. Methods: A study was conducted of 53 positive non-clonal K. pneumoniae bla KPC isolates from rectal swabs collected at several hospitals in Guayaquil, Ecuador, from January to June 2016. Minimum inhibitory meropenem concentration was determined by agar dilution (reference method), the Vitek 2 Compact system (AST-N272) and M.I.C.E.TM strips. Determination was made of MIC 50, MIC 90 and essential agreement. Results: The meropenem MIC range for the isolates studied was 1 to ≥ 32 µg/ml, with MIC50= 4 µg/ml and MIC90= ≥ 32 µg/ml. In 86.79 percent (n= 46) of the isolates MIC was ≤ 8 µg/ml. Essential agreement was 94.33 percent with the M.I.C.E.TM strips and under 50 percent with the AST-N272 card. Conclusions: The results obtained suggest potential implications for the treatment of patients, since therapeutic options are reduced in difficult management contexts. They also highlight the need for confirmation of carbapenem resistance by the Kirby-Bauer procedure in laboratories equipped with automated methods for susceptibility studies(AU)


Subject(s)
Humans , Microbial Sensitivity Tests/methods , Enterobacteriaceae Infections/drug therapy , Meropenem/therapeutic use , Klebsiella pneumoniae , Ecuador
13.
Rev. chil. infectol ; 37(5): 566-569, nov. 2020. tab
Article in Spanish | LILACS | ID: biblio-1144252

ABSTRACT

Resumen Introducción: Los abscesos hepáticos primarios producidos por Klebsiella pneumoniae y las implicancias sistémicas relacionadas constituyen el síndrome de absceso hepático invasor por Klebsiella pneumoniae. Objetivo: Describir las características clínicas, epidemiológicas y la evolución de esta entidad en nuestro centro. Pacientes y Métodos: Cohorte retrospectiva de pacientes adultos internados en el Hospital Italiano de Buenos aires entre el 1 de enero de 2001 y el 1 de mayo de 2020. Se incluyeron pacientes con diagnóstico de absceso en cualquier órgano con aislamiento en cultivo de absceso o hemocultivo positivo para Klebsiella pneumoniae para ser analizadas las características epidemiológicas, clínicas y la evolución de aquellos con localización primaria hepática. Resultados: 10 pacientes fueron incluidos. Dos (20%) pacientes fueron orientales. La mediana de edad fue 69 años (IIC 64-79), nueve (90%) fueron hombres. La co-morbilidad más frecuente fue diabetes mellitus tipo 2 (40%). Cuatro (40%) pacientes tuvieron diseminación a otros órganos. La mediana de internación fue 21,5 días (IIC 15-43), 60% (n: 6) requirió internación en unidad de cuidados intensivos y 30% (n: 3) de los pacientes falleció. Conclusión: El síndrome de absceso hepático invasor por Klebsiella pneumoniae es una enfermedad infrecuente, potencialmente mortal. Este estudio intenta reportar las características de los pacientes con esta patología en nuestra población.


Abstract Background: Primary liver abscesses caused by Klebsiella pneumoniae and their related systemic complications produce the invasive liver abscess syndrome due to Klebsiella pneumoniae. Aim: To describe the clinical, epidemiological and evolution characteristics in our center. Methods: A retrospective cohort of hospitalized adults in Hospital Italiano de Buenos Aires between January 1st, 2001 and May 1st, 2020. We included patients with diagnosis of abscess in any organ with rescue in culture or positive blood culture for Klebsiella pneumoniae. Epidemiological, clinical characteristics and prognosis of those with hepatic primary localization were analyzed. Results: 10 patients were included. Two (20%) patients were Oriental. Median age was 69 years (interquartile range 64-79), nine (90%) were men. The most frequent comorbidity was type 2 diabetes (40%). Four (40%) patients had spread to other organs. The median hospitalization was 21.5 days (IIC 15-43), 60% (n: 6) were hospitalized in the intensive care unit and 30% (n: 3) died. Conclusions: The invasive liver abscess syndrome due to Klebsiella pneumoniae is a rare life-threatening disease. Our study reports the characteristics of patients with this syndrome in our population.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Klebsiella Infections/diagnosis , Klebsiella Infections/epidemiology , Liver Abscess/epidemiology , Retrospective Studies , Diabetes Mellitus, Type 2 , Klebsiella pneumoniae
14.
An. bras. dermatol ; 95(5): 623-626, Sept.-Oct. 2020. graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS | ID: biblio-1130949

ABSTRACT

Abstract The authors report a rare case of primary cutaneous mucormycosis caused by Mucor irregularis and cutaneous Klebsiella pneumoniae infections in a 67-year-old Chinese woman. After the administration of liposomal amphotericin B combined with cefoperazone/sulbactam sodium, the patient recovered. Invasive fungal infection combined with cutaneous bacterial infection should receive attention.


Subject(s)
Humans , Female , Aged , Coinfection/drug therapy , Mucormycosis/complications , Mucormycosis/drug therapy , Skin , Klebsiella pneumoniae , Mucor , Antifungal Agents/therapeutic use
15.
Rev. chil. infectol ; 37(4): 362-370, ago. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1138560

ABSTRACT

Resumen Introducción: Las enterobacterias son una causa principal de infecciones del torrente sanguíneo y su resistencia antimicrobiana se encuentra en aumento. Esto lleva a un incremento de la morbilidad-mortalidad y de los costos en la salud pública. Las enterobacterias resistentes a carbapenems representan un grave desafío a nivel global ya que existen escasas opciones terapéuticas disponibles. Objetivo: Caracterización clínico/microbiológica de las bacteriemias resistentes a carbapenémicos observadas en un período de 4 años. Material y Método: Estudio retrospectivo, observacional y descriptivo, sobre las bacteriemias por enterobacterias resistentes y sensibles a carbapenems. Resultados: Se analizó un total de 84 pacientes con bacteriemia por enterobacterias resistentes y sensibles a carbapenems. Entre las resistentes, observamos una mayor proporción de: tratamiento antimicrobiano previo, hospitalización en unidad de terapia intensiva (UTI), inicio de la bacteriemia en UTI y antecedentes de β-lactamasas de espectro extendido. Además, se detectó un amplio predominio de Klebsiella pneumoniae productor de KPC y una mortalidad atribuible de 52,4%. Discusión: El estudio posibilitó profundizar el conocimiento de una enfermedad emergente de elevada mortalidad, en vistas al diseño y aplicación de estrategias de control de infecciones y de esquemas de tratamiento efectivos adaptados a la epidemiologia local.


Abstract Background: Enterobacteriaceae are a major cause of bloodstream infections and their antimicrobial resistance continues to increase. This leads to higher morbidity-mortality rates and public health costs. Carbapenem-resistant Enterobacteriaceae represent a serious challenge globally, since there are few therapeutic options available. Aim: Clinical/microbiological characterization of the carbapenem-resistant bacteremia observed over a period of 4 years. Methods: Retrospective, observational and descriptive study about bacteremia caused by carbapenem-resistant and susceptible Enterobacteriaceae. Results: A total of 84 patients with bacteremia including carbapenem-resistant and susceptible Enterobacteriaceae were analyzed. We found that patients infected with carbapenem-resistant strains presented a higher proportion of: previous antibiotic treatment, hospitalization in intensive care unit (ICU), onset of the bacteremia during hospitalization in ICU and previous infection with extended-spectrum-beta-lactamase producing Enterobacteriaceae. Additionally, we observed a predominance of KPC-producing Klebsiella pneumoniae and an attributable mortality rate of 52.4%. Discussion: This study allowed for a better understanding of an emerging problem with high mortality, which in turn is useful for the design and adoption of infection control strategies and effective treatment regimens adapted to our local epidemiology.


Subject(s)
Humans , Klebsiella Infections/drug therapy , Klebsiella Infections/epidemiology , Bacteremia/drug therapy , Bacteremia/epidemiology , Argentina/epidemiology , beta-Lactamases , Microbial Sensitivity Tests , Carbapenems/pharmacology , Retrospective Studies , Drug Resistance, Bacterial , Enterobacteriaceae , Klebsiella pneumoniae , Anti-Bacterial Agents/therapeutic use , Anti-Bacterial Agents/pharmacology
16.
Rev. ecuat. pediatr ; 21(2): 1-11, 31 de agosto del 2020.
Article in Spanish | LILACS | ID: biblio-1141081

ABSTRACT

Introducción: Las infecciones nosocomiales ocasionan un costo para el sistema de salud. En este estudio se reporta los datos observacionales de un brote de Klebsiella Pneumoniae en una Unidad de neonatología, y sus medidas posteriores a la identificación. Métodos: Con un diseño descriptivo observacional, ambispectivo se estudiaron casos de infecciones nosocomiales. Se realizaron medidas de barrera estrictas con listas de chequeo y uso de cámaras de vigilancia en una Unidad de Neonatología. Se reportan las observaciones del estudio. Se utiliza estadística descriptiva. Resultados: 6 casos fueron diagnosticados con Klebsiella Pneumoniae, todos fueron pacientes recién nacidos prematuros, tres de ellos extremos. Cuatro pacientes con sepsis temprana. Las muestras de cultivos fueron 3 Hemocultivos, 2 Urocultivos y 1 cultivo de secreción faríngea. Junto con el cultivo de Klebsiella pneumoniae, se identificaron otros patógenos. La coinfección de Klebsiella con S. aureus fue la que se mantuvo más días en aislamiento, en relación al aislamiento de Klebsiella sola. De todos los cultivos, 2 fueron positivos para Klebsiella pneumoniae productora de BLEE, y cuatro para Klebsiella pneumoniae multisensible. Luego de la intervención no se presentaron nuevo casos con un seguimiento de 12 meses posteriores al brote. Conclusiones: Luego del brote de 6 casos de Klebsiella Pneumoniae en la unidad de Neonatología se establecieron medidas estrictas de bioseguridad, las mismas que fueron cumplidas con el registro en listas de chequeo y monitorizadas por cámaras de seguridad. Se logró la eliminación de infecciones nosocomiales en un período de control posterior a 12 meses luego de la implementación


Introduction: Nosocomial infections cause a cost for the health system. This study reports the observational data of an outbreak of Klebsiella Pneumoniae in a neonatology unit, and its measures after identification. Methods: With a descriptive, observational, ambispective design, nosocomial infections were studied. Strict barrier measures were carried out with checklists and the use of surveillance cameras in a Neonatology Unit. Study observations are reported. Descriptive statistics are used. Results: 6 cases were diagnosed with Klebsiella Pneumoniae, all were premature newborn patients, three of them extreme. Four patients with early sepsis. The culture samples were 3 blood cultures, 2 urine cultures and 1 culture of pharyngeal secretion. Along with the Klebsiella pneumoniae culture, other pathogens were identified. Klebsiella co-infection with S. aureus was the one that remained in isolation for more days, in relation to Klebsiella isolation alone. Of all the cultures, 2 were positive for ESBL-producing Klebsiella pneumoniae, and four for multisensitive Klebsiella pneumoniae. After the intervention, no new cases were presented with a follow-up of 12 months after the outbreak. Conclusions: After the outbreak of 6 cases of Klebsiella Pneumoniae in the Neonatology unit, strict biosafety measures were established, which were complied with with the registration in checklists and monitored by security cameras. Elimination of nosocomial infections was achieved in a control period after 12 months after implementation


Subject(s)
Humans , Klebsiella Infections , Klebsiella pneumoniae , Neonatology , Intensive Care Units, Neonatal , Critical Care
17.
Rev. chil. infectol ; 37(3): 295-303, jun. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1126122

ABSTRACT

Resumen Introducción: Las enterobacterias productoras de carbapenemasas (EPC) suponen un reto para la salud pública y la práctica clínica. Objetivo: Analizar la epidemiología, el tratamiento y la mortalidad en pacientes infectados por EPC. Material y Métodos: Análisis retrospectivo de 163 pacientes infectados por EPC en un hospital universitario desde julio de 2013 a octubre de 2015. Resultados: Klebsiella pneumoniae fue aislada en 95,1% de los casos, y la mayoría de las carbapenemasas pertenecían al grupo OXA-48 (93%). La adquisición fue nosocomial en 124 casos (77%), asociada a cuidados sanitarios en 30 (18,6%), y 7 (4,3%) fueron de adquisición comunitaria. Las infecciones más frecuentes fueron las del tracto urinario (48,4%) y las respiratorias (19,5%). Aproximadamente, la mitad de los pacientes recibieron monoterapia antimicrobiana. La tasa de mortalidad a los 30 días fue de 23,3%. El análisis multivariante identificó que la presencia de shock séptico al diagnóstico (OR 4,2; IC 95% 1,5-11) estaba asociada de manera independiente con mayor mortalidad en el primer mes, sin lograr identificar asociación con el tratamiento antimicrobiano inapropiado. Discusión: Son necesarios más estudios para aclarar si el tratamiento antimicrobiano de las infecciones por EPC debe ser combinado o si podría ser suficiente la monoterapia en infecciones leves.


Abstract Background: Carbapenemase-producing Enterobacteriaceae (CPE) has become a significant problem in terms of public health and clinical outcome. Objective: To assess the epidemiology, treatment and mortality in patients with infection due to CPE. Material and Methods: A retrospective analysis of 163 patients with CPE infection was carried out in a university hospital from July 2013 to October 2015. Results: A total of 163 patients were included over the study period. Klebsiella pneumoniae was isolated in 95.1% of cases, and most of carbapenemases belonged to the OXA-48 group (93.0%). Acquisition was nosocomial in 124 cases (77.0%), healthcare-associated in 30 (18.6%), and 7 cases (4.3%) were community-acquired. The most frequent infections identified in this study were urinary tract (48.4%) and respiratory (19.5%) infections. Approximately half of the patients received antibiotic monotherapy. The 30-day mortality rate was 23.3%. Multivariate analysis revealed that the presence of septic shock at diagnosis (OR 4.2; IC 95% 1.5-11) was independently associated with an increase in death during the first month, unable to identify association with inappropriate antibiotic treatment. Discussion: Further studies are needed to clarify whether antibiotic treatment of EPC infections should be combined or if monotherapy might be sufficient in mild infections.


Subject(s)
Humans , Enterobacteriaceae Infections , Carbapenem-Resistant Enterobacteriaceae , Bacterial Proteins , beta-Lactamases , Retrospective Studies , Klebsiella pneumoniae , Anti-Bacterial Agents
18.
Infectio ; 24(1): 42-49, ene.-mar. 2020. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1090542

ABSTRACT

Resumen Objetivo: Determinar los mecanismos de resistencia antibiótica y la epidemiología molecular de aislados clínicos de Klebsiella pneumoniae resistentes a carbapenémicos. Materiales y métodos: 30 aislados multirresistentes de K. pneumoniae fueron obtenidos a partir de: urocultivo, aspirado traqueal, secreción de herida, sonda vesical, hemocultivo, líquido peritoneal, punta de catéter, colección abdominal y secreción bronquial. Los aislados fueron colectados de noviembre de 2012 a abril de 2013. La identificación y susceptibilidad antibiótica fue determinada por el sistema automatizado VITEK 2. Para la amplificación de genes de resistencia se empleó PCR, la determinación de las Secuencias Tipo (ST) fue obtenida por tipificación multilocus de secuencias (MLST) y la relación clonal fue establecida por electroforesis en gel de campo pulsado (PFGE). Resultados: Todos los aislados mostraron fenotipos multirresistentes, excepto a colistina y tigeciclina. El 100% de los aislados fue productor de la carbapenemasa KPC-2. La determinación de la presencia de genes codificantes de β-lactamasas de Espectro Extendido mostró que el 67% de los aislados fue positivo para el gen blaCTX-M, el 100% fue positivo para el gen blaSHV y 93% fue positivo para el gen blaTEM. El análisis de la relación clonal de los 30 aislados agrupó a 20 en un mismo pulso tipo. El análisis por MLST demostró que la ST predominante fue ST258 presente en el 60% de la población, seguida de ST1199 presente en el 20% de la población analizada. Conclusiones: Los resultados obtenidos demuestran la importancia de implementar y combinar estudios epidemiológicos, clínicos y moleculares para comprender la distribución de la resistencia entre bacterias de interés clínico.


Abstract Objective: To determine the mechanism of antibiotic resistance and molecular epidemiology of carbapenem resistant isolates of Klebsiella pneumoniae. Materials and Methods: 30 multidrug resistant isolates of K. pneumoniae were obtained from urine culture, tracheal aspirate, wound secretion, bladder catheter, blood culture, peritoneal fluid, catheter tip, abdominal collection, and bronchial secretion. K. pneumoniae isolates were collected between November 2012 and April 2013. Identification and susceptibility were determined by the VITEK 2 system. Resistance genes were identified by PCR, sequence type (ST) was established by multilocus sequence typing (MLST), and clonal relationship was defined by pulsed field gel electrophoresis (PFGE). Results: All isolates were multidrug resistant and susceptible to colistin and tigecycline. 100% of isolates produced KPC-2 carbapenemase. This study detected Extended Spectrum β-Lactamases enconding genes. 67% of isolates were positive for blaCTX-M, 100% were positive for blaSHV, and 93% of isolates were positive for blaTEM. Analysis of the clonal relationship clustered 20 isolates in the same clonal complex. Multilocus sequence typing showed the predominant sequence type ST 258 in 60% of population. ST 1199 were present in 20% of bacterial population. Conclusion: Molecular epidemiology, clinical research and molecular biology studies improve understanding of mechanisms of resistance distribution among bacteria of clinical interest.


Subject(s)
Humans , Carbapenem-Resistant Enterobacteriaceae , Klebsiella pneumoniae , Drug Resistance, Microbial , Epidemiologic Studies , Gene Amplification , Multilocus Sequence Typing , Clinical Studies as Topic
20.
Rev. Soc. Bras. Med. Trop ; 53: e20200032, 2020. tab, graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS, SES-SP | ID: biblio-1136877

ABSTRACT

Abstract INTRODUCTION: Essential oils can serve as novel sources of antibiotics for multidrug-resistant bacteria. METHODS: The multidrug-resistance profile of a Klebsiella aerogenes strain was assessed by PCR and sequencing. The antibacterial activity of Cinnamomum cassia essential oil (CCeo) against K. aerogenes was assessed by broth microdilution and time-kill methods. RESULTS: K. aerogenes showed high antibiotic resistance. The genes bla KPC-2, ampC, bla CTX-M-15, bla OXA-1, and bla TEM were present. CCeo exhibited an inhibitory effect with a minimum inhibitory concentration of 17.57 μg/mL. CONCLUSIONS: The antibacterial activity of CCeo makes it a potential candidate for treating carbapenem- and polymyxin-resistant K. aerogenes strains.


Subject(s)
Humans , Klebsiella Infections/drug therapy , Enterobacter aerogenes , Cinnamomum aromaticum , Anti-Bacterial Agents/therapeutic use , beta-Lactamases , Oils, Volatile , Carbapenems , Polymyxins , Klebsiella pneumoniae
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