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1.
Arch. pediatr. Urug ; 92(2): e212, dic. 2021. tab
Article in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1339132

ABSTRACT

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


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


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


Subject(s)
Humans , Female , Infant, Newborn , Staphylococcal Infections/epidemiology , Neonatal Sepsis/epidemiology , Staphylococcal Infections/diagnosis , Staphylococcal Infections/drug therapy , Staphylococcus epidermidis/virology , Uruguay/epidemiology , Vancomycin/therapeutic use , Cross Infection , Epidemiology, Descriptive , Incidence , Retrospective Studies , Longitudinal Studies , Coagulase , Staphylococcus haemolyticus/virology , Staphylococcus hominis/virology , Anti-Bacterial Agents/therapeutic use
2.
Arch. argent. pediatr ; 119(1): 11-17, feb. 2021. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1147054

ABSTRACT

Introducción. Las infecciones por Staphylococcus aureus resistente a meticilina adquirido de la comunidad (SARM-AC) se han incrementado en los últimos años. Neumonías necrotizantes y empiemas por SARM-AC son cada vez más frecuentes en niños.Objetivos. Determinar la prevalencia de neumonías por SARM-AC y sus características clínico-epidemiológicas, en comparación con las neumonías por Streptococcus pneumoniae (SP) en la misma población.Material y métodos. Estudio descriptivo, observacional, transversal, de pacientes internados con neumonía por SARM-AC en el Hospital de Niños Víctor J. Vilela (período: 1/2008-12/2017).Resultados. De 54 neumonías por Staphylococcus aureus, 46 (el 85 %) fueron SARM-AC. El índice de neumonías por SARM-AC varió de 4,9/10 000 (2008) a 10/10 000 egresos (2017). Presentaron sepsis/shock séptico el 41 %; empiema, el 96 %; neumotórax, el 35 %; requirieron drenaje pleural el 90 % y toilette quirúrgica el 55 %. Ingresaron a Terapia Intensiva el 65 %; la mitad necesitó asistencia respiratoria mecánica. Hubo dos muertes. Resistencia de las cepas: el 17 % a gentamicina, el 13 % a eritromicina, el 11 % a clindamicina. En las neumonías por SARM-AC vs. las neumonías por SP, se observó mayor riesgo de sepsis (IC 95 %; RR 7,38; 3,32-16,38) e ingreso a Terapia Intensiva (RR 4,29; 2,70-6,83). No hubo muertes por SP.Conclusiones. La prevalencia de neumonías por SARM-AC se duplicó durante la última década. Comparadas con las neumonías por SP, las neumonías por SARM-AC se acompañaron, más frecuentemente, de cuadros de sepsis y shockséptico, ingreso a Terapia Intensiva y asistencia respiratoria.


Introduction. Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections have increased in recent years. CA-MRSA necrotizing pneumonia and empyema are now more common in children.Objectives. To determine the prevalence of CA-MRSA pneumonia and its clinical and epidemiological characteristics compared to Streptococcus pneumoniae (SP) pneumonia in the same population.Material and methods. Descriptive, observational, cross-sectional study of patients hospitalized due to CA-MRSA pneumonia at Hospital de Niños Víctor J. Vilela (period: January 2008-December 2017).Results. Out of 54 Staphylococcus aureus pneumonia cases, 46 (85 %) corresponded to CA-MRSA. The rate of CA-MRSA pneumonia ranged from 4.9/10 000 (2008) to 10/10 000 hospital discharges (2017). Sepsis/septic shock was observed in 41 %; empyema, in 96 %; pneumothorax, in 35 %; 90 % of cases required pleural drainage and 55 %, surgical debridement. Also, 65 % of patients were admitted to the intensive care unit (ICU); half of them required assisted mechanical ventilation. Two patients died. Strain resistance: 17 %, gentamicin; 13 %, erythromycin; and 11 %, clindamycin. Compared to SP pneumonia, CA-MRSA pneumonia showed a higher risk for sepsis (95 % confidence interval; relative risk: 7.38; 3.32-16.38) and admission to the ICU (RR: 4.29; 2.70-6.83). No patient died due to SP pneumonia.Conclusions. The prevalence of CA-MRSA pneumonia doubled in the past decade. Compared to SP pneumonia, CA-MRSA pneumonia was more commonly accompanied by sepsis and septic shock, admission to the ICU, and ventilatory support requirement


Subject(s)
Humans , Male , Female , Child , Adolescent , Staphylococcal Infections/epidemiology , Community-Acquired Infections/epidemiology , Methicillin-Resistant Staphylococcus aureus , Argentina/epidemiology , Staphylococcal Infections/diagnosis , Staphylococcal Infections/microbiology , Microbial Sensitivity Tests , Epidemiology, Descriptive , Incidence , Prevalence , Cross-Sectional Studies , Community-Acquired Infections/diagnosis , Community-Acquired Infections/microbiology , Hospitals, Pediatric
3.
Rev. chil. infectol ; 37(5): 570-576, nov. 2020. tab, graf
Article in Spanish | LILACS, BNUY | ID: biblio-1144253

ABSTRACT

Resumen Introducción: La endocarditis infecciosa (EI) es causa importante de morbimortalidad. En los últimos años se han visto cambios en la epidemiología de esta enfermedad. Objetivo: Describir las características epidemiológicas, clínicas y microbiológicas de pacientes con diagnóstico de EI ingresados en un hospital pediátrico de 2011 al 2018. Pacientes y Método: Estudio observacional, descriptivo, retrospectivo. Se incluyeron pacientes bajo 15 años de edad, hospitalizados con EI en un hospital pediátrico de referencia de Uruguay. Se utilizaron cálculos de medidas de tendencia central y dispersión, así como frecuencias absolutas y porcentuales. Resultados: Se identificaron 11 niños, media de edad 4 años 6 meses (rango 5 meses - 13 años). Cinco sin factores de riesgo, seis con factores de riesgo: cinco con cardiopatía congénita (2 con cirugía cardíaca) y uno con catéter venoso central. En 11 se obtuvo hemocultivo previo a la antibioterapia, en 10 una sola muestra, en uno hubo dos muestras. En nueve casos se recuperó el microorganismo causal; Staphylococcus aureus en cuatro (dos cepas resistentes a meticilina), seguido de Streptococcus grupo viridans tres niños. En 10 niños se encontraron vegetaciones en el ecocardiograma, seis valvulares. El tratamiento empírico más frecuente fue ceftriaxona y vancomicina. Las complicaciones fueron falla cardiaca y embolias sépticas. Cinco niños requirieron cirugía cardíaca. Falleció un paciente. Conclusiones: Se observó un aumento de EI en niños sin cardiopatía, por tanto, es necesario tener alta sospecha clínica en pacientes febriles. Importante es realizar hemocultivos previos al inicio de la antibioterapia y contemplar una cobertura contra Staphylococcus aureus en la terapia empírica inicial.


Abstract Background: Infective endocarditis (IE) is an important cause of morbidity and mortality. In recent years there have been changes in the epidemiology of this disease. Aim: To describe epidemiological, clinical and microbiological characteristics of patients with a diagnosis of IE admitted to a pediatric hospital from 2011 to 2018. Methods: Observational, descriptive, retrospective study. Children under 15 years of age hospitalized with IE in a reference pediatric hospital in Uruguay were included. Calculations of measures of central tendency and dispersion were used, as well as absolute and percentage frequencies. Results: 11 children were identified, mean age 4 years 6 months (range 5 months - 13 years). Five without risk factors, 6 with risk factors: 5 congenital heart disease (2 with cardiac surgery) and 1 central venous catheter. In 11 blood cultures were obtained prior to antibiotics, 10 a single sample, 1 with two samples. In 9 cases a microorganism was isolated. The most frequent was Staphylococcus aureus 4 children (2 methicillin resistant), followed by group viridans Streptococcus 3 children. In 10 children vegetations were found in the echocardiogram, 6 valvular. The most frequent empirical treatment was ceftriaxone and vancomycin. Complications were heart failure and septic emboli. 5 children required heart surgery. One patient died. Conclusions: An increase of IE in children without heart disease has been observed, then, it is necessary to have high clinical suspicion in febrile patients. It is important to perform blood cultures prior to the start of antibiotics and to consider coverage against Staphylococcus aureus in empirical initial treatment.


Subject(s)
Humans , Male , Child, Preschool , Child , Adolescent , Staphylococcal Infections/drug therapy , Staphylococcal Infections/epidemiology , Endocarditis, Bacterial/drug therapy , Endocarditis, Bacterial/epidemiology , Uruguay/epidemiology , Retrospective Studies
4.
Rev. cuba. med. gen. integr ; 36(3): e1192, jul.-set. 2020.
Article in Spanish | LILACS, CUMED | ID: biblio-1138976

ABSTRACT

Introducción: En la superficie cutánea residen microorganismos responsables del balance bioquímico, algunas son patógenas y persisten a pesar del lavado de manos. Objetivo: Identificar la flora bacteriana resistente al lavado de manos en estudiantes universitarios. Métodos: Se realizó el estudio observacional analítico de tipo longitudinal, para esto se enrolaron a estudiantes universitarios que recibieron previamente charlas educativas sobre higiene de manos, posteriormente se tomaron muestras antes y después del lavado de las manos. Resultados: De 80 muestras analizadas se identificó a Staphylococcus epidermidis como el más frecuente en 95 por ciento de los estudiantes y con el lavado de manos se redujo a 60 por ciento; el segundo agente fue Staphylococcus saprophyticcus, que estuvo presente en 75 por ciento de los casos y después del lavado, en 35 por ciento; E. coli ocupó el tercer lugar, se encontró en 42,5 por ciento de las muestras y tras la higiene de manos se redujo a 17,5 por ciento. Para los agentes transitorios como Klebsiella (p < 0,05) y Pseudomonas, el lavado de manos fue más efectivo; sin embargo, E. coli fue la enterobacteria que permaneció elevada a pesar de la higiene de manos (p = 0,01). Conclusión: Algunas colonias de E. coli son resistentes al lavado de manos, similar a los agentes residentes como Staphylococcus epidermidis, Staphylococcus saprophyticcus y Staphylococcus aureus(AU)


Introduction: The skin surface is inhabited by microorganisms responsible for the biochemical balance; some are pathogenic and persist despite hand washing. Objective: To identify, in university students, the bacterial flora resistant to hand washing. Methods: A longitudinal, analytical and observational study was carried out, for which university students were included who previously received educational talks on hand hygiene. Samples were taken before and after hand washing. Results: Of 80 samples analyzed, Staphylococcus epidermidis was identified as the most frequent in 95 percent of the students and, with hand washing, it was reduced to 60 percent the second agent was Staphylococcus saprophyticcus, present in 75 percent of the cases and, after hand washing, in 35 percent. E. coli occupied the third position, as it was found in 42.5 percent of the samples and, after hand hygiene, it was reduced to 17.5 percent. For transient agents like Klebsiella (P<0.05) and Pseudomonas, handwashing was more effective; however, E. coli was the enterobacterium that remained elevated despite hand hygiene (P=0.01). Conclusion: Some E. coli colonies are resistant to hand washing, similar to resident agents such as Staphylococcus epidermidis, Staphylococcus saprophyticcus and Staphylococcus aureus(AU)


Subject(s)
Humans , Male , Female , Staphylococcal Infections/epidemiology , Hand Disinfection , Escherichia coli Infections/epidemiology , Longitudinal Studies , Observational Study
5.
Rev. chil. infectol ; 37(1): 37-44, feb. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1092720

ABSTRACT

Resumen Introducción: Staphylococcus aureus es uno de los patógenos con mayor prevalencia en el mundo, asociado a una alta tasa de mortalidad y un rápido desarrollo de resistencia a los antimicrobianos. A pesar de su patogenicidad, su seguimiento epidemiológico en México es escaso. Objetivo: Analizar la epidemiología molecular local y determinar el origen clonal de cepas resistentes a meticilina (RM) aisladas de pacientes internados en el Hospital Central "Dr. Ignacio Morones Prieto". Métodos: Se llevó a cabo un estudio prospectivo de corte transversal, de julio a diciembre de 2016. La caracterización de las cepas se realizó mediante genotipificación Spa, la determinación por RPC punto final de la frecuencia de genes de virulencia específicos y su antibiograma. Resultados: A partir de estos datos, se obtuvo que la prevalencia de S. aureus RM fue de 25,7%, destacando la presencia del tipo Spa t895 en 76% de las cepas resistentes y un patrón similar de susceptibilidad a antimicrobianos. Conclusión: Los resultados de este estudio indican que la prevalencia regional de SARM no se ha modificado en los últimos 10 años y proporcionan información valiosa del origen clonal y los factores de virulencia de las cepas de S. aureus aisladas en la región.


Abstract Background: Staphylococcus aureus is one of most prevalent pathogens in the world associated with a high mortality rate and a rapid development of resistance to antibiotics. Despite its pathogenicity, epidemiological monitoring in Mexico is scarce. Aim: To analyze the local molecular epidemiology and determine the clonal origin of methicillin-resistant (MR) strains isolated from patients admitted to Hospital "Dr. Ignacio Morones Prieto". Methods: A cross-sectional prospective study was carried out from July to December 2016. The characterization of the strains was carried out by Spa genotyping, frequency of specific virulence genes by PCR and antibiogram. Results: The prevalence of MRSA was 25.7%, highlighting the presence of the Spa type t895 in 76% of the resistant strains and a similar pattern of susceptibility to antibiotics. Conclusion: The results of this study indicate that the regional prevalence of MRSA has not changed in the last 10 years and provide valuable information on the clonal origin and the virulence factors of the strains of S. aureus isolated in the region.


Subject(s)
Humans , Staphylococcal Infections/microbiology , Staphylococcal Infections/epidemiology , Methicillin-Resistant Staphylococcus aureus/classification , Methicillin-Resistant Staphylococcus aureus/drug effects , Methicillin-Resistant Staphylococcus aureus/genetics , Microbial Sensitivity Tests , Prevalence , Cross-Sectional Studies , Prospective Studies , Virulence Factors/genetics , Genotype , Mexico/epidemiology , Anti-Bacterial Agents/pharmacology
6.
Rev. Soc. Bras. Med. Trop ; 52: e20190095, 2019. tab, graf
Article in English | LILACS | ID: biblio-1013299

ABSTRACT

Abstract INTRODUCTION Staphylococcus aureus is a major nosocomial pathogen that is associated with high virulence and the rapid development of drug resistance. METHODS We analyzed and compared the antimicrobial resistance, virulence profiles, and molecular epidemiology of 67 S. aureus strains, including 36 methicillin-sensitive (MSSA) and 31 methicillin-resistant (MRSA) strains recovered from a public hospital located in south-eastern Brazil. RESULTS The clones circulating in this hospital presented a great diversity, and the majority of the strains were related to clones responsible for causing worldwide epidemics: these included USA100 (New York/Japan clone), USA300, and USA600. The 31 MRSA (22 SCCmecII and 9 SCCmecIV) and 36 MSSA strains exhibited low resistance against gentamicin and trimethoprim/sulfamethoxazole. No MRSA strain showed resistance to tetracycline. Virulence gene carriage was more diverse and abundant in MSSA than in MRSA. Of the evaluated adhesion-related genes, ebpS was the most prevalent in both MSSA and MRSA strains. The genes bbp and cna showed a strong association with MSSA strains. CONCLUSIONS Our findings reinforce the idea that MSSA and MRSA strains should be carefully monitored, owing to their high pathogenic potential.


Subject(s)
Humans , Staphylococcus aureus/drug effects , Staphylococcus aureus/genetics , Methicillin Resistance , Virulence Factors/genetics , Methicillin-Resistant Staphylococcus aureus/genetics , Anti-Bacterial Agents/pharmacology , Staphylococcal Infections/epidemiology , Staphylococcus aureus/isolation & purification , Staphylococcus aureus/classification , Virulence/genetics , Brazil/epidemiology , Microbial Sensitivity Tests , Molecular Epidemiology , Tertiary Care Centers , Hospitals, Public
7.
Braz. j. infect. dis ; 22(5): 371-376, Sept.-Oct. 2018. tab, graf
Article in English | LILACS | ID: biblio-974237

ABSTRACT

ABSTRACT Background: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is spreading worldwide, but little is known about the epidemiology of this pathogen in Brazil. Objective: To evaluate clinical and microbiological features of children with S. aureus infections admitted to a university hospital. Methods: This was a cross-sectional study evaluating the potential risk factors for CA-MRSA, and a retrospective cohort evaluating in-hospital clinical outcomes. To include patients with both community and hospital-associated infections, we screened the results of the microbiological laboratory tests from January 1, 2012, to December 31, 2016. According to the phenotype, we classified the isolates in Methicillin-Susceptible S. aureus (MSSA), Hospital-Associated Methicillin-Resistant S. aureus (HA-MRSA), and CA-MRSA. Clinical data were collected from the patients' medical records. Results: We identified 279 cases of S. aureus infections (MSSA = 163, CA-MRSA = 69, HA-MRSA = 41). Overall, the incidence density of CA-MRSA and MSSA infections increased while the HA-MRSA incidence density decreased over the study period. CA-MRSA infected patients were more likely to present with skin and soft tissue infections (OR: 2.83, 95%CI: 1.54-5.33, p < 0.001) and osteomyelitis (OR: 4.76; 95%CI: 1.16-22.71, p = 0.014) when compared to MSSA and HA-MRSA infections. Unadjusted case fatality rates were similar between MSSA-infected patients (3.14%, 5/159) and CA-MRSA infected patients (3.80%, 3/79, p = 0.792), while HA-MRSA infected patients were more likely to die in the hospital (12.20%, 5/41, p = 0.013). Conclusions: CA-MRSA is an emergent pediatric pathogen in Brazil. Our results highlight the relevance of choosing an appropriate initial antimicrobial drug for treating children with severe S. aureus infections.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Staphylococcal Infections/microbiology , Staphylococcal Infections/epidemiology , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Phenotype , Reference Values , Staphylococcal Infections/drug therapy , Time Factors , Brazil/epidemiology , Incidence , Cross-Sectional Studies , Retrospective Studies , Risk Factors , Community-Acquired Infections/microbiology , Community-Acquired Infections/drug therapy , Community-Acquired Infections/epidemiology , Statistics, Nonparametric , Anti-Bacterial Agents/therapeutic use
8.
Rev. salud pública Parag ; 8(2): [P28-P33], Jul - Dic 2018.
Article in Spanish | LILACS | ID: biblio-980586

ABSTRACT

Introducción: El Staphylococcus Aureus constituye un agente etiológico frecuente de intoxicaciones alimentarias y se encuentra asociado a diversos alimentos. Objetivo: Describir la frecuencia de portación de Staphylococcus Aureus en manipuladores de alimentos de restaurantes de Asunción durante el 2017. Metodología: Se realizó un estudio observacional, prospectivo, descriptivo de corte transversal a manipuladores de alimentos de restaurantes de Asunción durante los meses de mayo a junio del 2017. Se realizaron tres hisopados nasales a cada uno de los 30 manipuladores de alimentos para determinar si la portación era intermitente, permanente u ocasional. Al mismo tiempo fueron realizadas encuestas donde se midieron variables demográficas. Resultados: La prevalencia de portación de Staphylococcus Aureus fue del 33,3 % (10), siendo el 40% (4) esporádica e intermitente y el 20% (2) permanente. En cuanto a las características demográficas de los manipuladores,el 56,66% (17) fueron del sexo masculino, eran solteros 43,33% (13) y el 50% (15) contaban con estudios secundarios completos. El promedio de edad de 29 de los manipuladores fue de 39,5 años con un rango comprendido entre 18 y 85 años. El 23,33% (7) utilizaban guantes a la hora de manipular los alimentos. Además, se pudo observar que el 26,66% (8) utilizaba gorros. Llamó la atención que el 30% (9) de los encuestados no presentaban uñas limpias durante la manipulación. Palabras clave: Staphylococcus Aureus; manipuladores; alimentos.


Introduction: Staphylococcus Aureus is a frequent etiologic agent of food poisoning and is associated with various foods. Objective : To describe the frequency of Staphylococcus Aureus in food handlers of restaurants in Asunción during 2017. Methodology: An observational, prospective, descriptive, cross-sectional study was carried out on food handlers in restaurants in Asuncion during the months of May to June 2017. Three nasal swabs were made to each of the 30 food handlers to determine if the carriage was intermittent, permanent or occasional. At thesame time, surveys were carried out where demographic variables were measured. Results: The prevalence of carrying Staphylococcus Aureus was 33.3% (10), being 40% (4) sporadic and intermittent and 20% (2) permanent. Regarding the demographic characteristics of the manipulators, 56.66% (17) were male, were single 43.33% (13) and 50% (15) had complete secondary education. The average age of 29 of the manipulators was 39.5 years with ranger between 18 and 85 years. 23.33% (7) used gloves when handling food. In addition, it was observed that 26.66% (8) used caps. It was noted that 30% (9) of theres pondents did not have clean nails during handling. Keywords: Staphylococcus Aureus; manipulators; food.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Staphylococcal Infections/epidemiology , Staphylococcus aureus/isolation & purification , Food Handling , Paraguay/epidemiology , Staphylococcal Infections/transmission , Staphylococcus aureus/drug effects , Drug Resistance, Microbial , Hygiene , Prevalence , Cross-Sectional Studies , Prospective Studies
9.
Arch. argent. pediatr ; 116(2): 119-125, abr. 2018. tab, graf
Article in English, Spanish | LILACS, BINACIS | ID: biblio-887457

ABSTRACT

Introducción: Las infecciones por Staphylococcus aureus meticilino resistente adquirido en la comunidad (SAMR-ac) son motivo de consulta frecuente en pediatría. La mayoría se presentan como infecciones de piel y partes blandas; sin embargo, en la última década, se ha constatado un aumento de las infecciones invasivas. Objetivos: El objetivo principal es describir las características clínico-epidemiológicas de las infecciones producidas por SAMR-ac. El objetivo secundario es comparar la prevalencia, presentación clínica y susceptibilidad antibiótica con un período previo de estudio (1/2004-12/2007). Material y métodos: Estudio descriptivo, prospectivo, de tipo transversal. Criterios de inclusión: niños con diagnóstico de infección por SAMR-ac admitidos en el Hospital de Niños de Rosario, período de enero de 2008 a diciembre de 2014. Criterios de exclusión: internación reciente, antibiótico o cirugía previa, comorbilidades o inmunocompromiso. Resultados: De 728 niños con infecciones por Staphylococcus aureus, 529 (73%) fueron por SAMR-ac. La tasa de incidencia de infecciones por SAMR-ac varió de 12,2/10 000 egresos hospitalarios de 2004 a 145/10 000 del 2014: 75% (391) fueron infecciones de piel y partes blandas; 8% (43), os teo articular es; 6% (30), pleuropulmonares; 5% (24), sepsis. Se observó un aumento en el número de infecciones invasivas en el 2º período sin significancia estadística (OR= 0,895; IC: 0,52-1,53). La resistencia a gentamicina, clindamicina y eritromicina se mantuvo estable en ambos períodos. Conclusión: Las infecciones por SAMR-ac fueron cada vez más frecuentes, principalmente, las de piel y partes blandas. Se observó un aumento en el número de infecciones invasivas sin significancia estadística. La resistencia antibiótica se mantuvo estable.


Introduction: Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are a common reason for consultation in pediatrics. Most of them present as skin and soft tissue infections; however, invasive infections have increased during the last decade. Objectives: The main objective was to describe the clinical-epidemiological characteristics of CA-MRSA infections. The secondary objective was to compare prevalence, clinical presentation and antibiotic susceptibility with a pre-study period (1/2004-12/2007). Material and methods: This is a descriptive, prospective, cross-sectional study. Inclusion criteria: children who have been diagnosed with CA-MRSA infection and admitted to Hospital de Niños de Rosario between January 2008 and December 2014. Exclusion criteria: recent hospitalization, previous antibiotic treatment or surgery, comorbidities or immune compromise. Results: Out of 728 cases of children with Staphylococcus aureus infections, 529 (73%) were due to CA-MRSA. The incidence rate of CA-MRSA infections varied from 12.2/10 000 hospital discharges in 2004 to 145/10 000 in 2014: 75% (391) were skin and soft tissue infections; 8% (43) were osteoarticular infections; 6% (30), pleuropulmonary infections; 5% (24), sepsis. There was an increase in the number of invasive infections in the second period, with no statistical significance (OR= 0.895; CI: 0.52-1.53). Gentamicin, clindamycin and erythromycin resistance remained stable throughout both periods. Conclusion: CA-MRSA infections were increasingly more frequent, mainly skin and soft tissue infections. An increase was observed in the number of invasive infections, with no statistical significance. Antibiotic resistance remained stable.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Staphylococcal Infections/epidemiology , Community-Acquired Infections/epidemiology , Methicillin-Resistant Staphylococcus aureus , Argentina/epidemiology , Staphylococcal Infections/diagnosis , Staphylococcal Infections/microbiology , Staphylococcal Infections/drug therapy , Microbial Sensitivity Tests , Incidence , Prevalence , Cross-Sectional Studies , Prospective Studies , Community-Acquired Infections/diagnosis , Community-Acquired Infections/microbiology , Community-Acquired Infections/drug therapy , Hospitals, Pediatric , Anti-Bacterial Agents/therapeutic use
10.
Medicina (B.Aires) ; 77(6): 465-468, dic. 2017. map, tab
Article in Spanish | LILACS | ID: biblio-894522

ABSTRACT

La asociación entre diseminación de infecciones comunitarias, pobreza y hacinamiento es bien conocida. En nuestro hospital observamos casos esporádicos de infecciones post-cesárea por cepas de Staphylococcus aureus meticilino resistente de origen comunitario (SAMRCo). En un estudio prospectivo de familias de José C. Paz atendidas en nuestro hospital, investigamos la relación entre antecedentes de infecciones de piel y partes blandas (IPPB) y hacinamiento extremo (hogares con necesidades básicas insatisfechas tipo 3, (NBI 3). Fueron incluidos 264 hogares; 109 (41.3%) tenían historia de IPPB y 59 (22.3%) eran NBI 3. El 61.0% de los hogares NBI 3 y el 35.6% de los hogares no NBI 3 refirieron IPPB (p = 0.00047). Georreferenciamos los domicilios con Google Maps y los ubicamos en un plano de José C. Paz NBI del censo nacional 2010. En barrios con un porcentaje de NBI > 9.7%, el 51.2% de los hogares tuvo antecedentes de IPPB. Cuando este porcentaje era ≤ 9.7% el porcentaje bajó al 31.1% (p = 0.0019). Estos resultados son sugestivos de diseminación comunitaria de estas infecciones asociada a hacinamiento y barrios pobres. Se debe considerar la presencia de SAMRCo en IPPB comunitarias. Por ello, en mujeres procedentes de zonas con alto porcentaje NBI o con antecedentes de IPPB se podría considerar la inclusión de la vancomicina o la clindamicina en la profilaxis de los partos por cesárea.


The association of the spread of community infections with poverty and overcrowding is well known. In our hospital, located in José C. Paz, we assist sporadic cases of post-cesarean infections caused by community acquired methicillin-resistant Staphylococcus aureus (CaMRSA). In a prospective study of families treated at our hospital, we investigated the relationship between a history of skin and soft tissue infections (SSTI) and extreme overcrowding defined as households with unsatisfied basic needs type 3 (NBI 3). A total of 264 households were included in the study; 109 (41.3%) had a history of SSTI and 59 (22.3%) were NBI 3. A total of 61.0% of the NBI 3 households and 35.6% of the non-NBI 3 households reported SSTI (p = 0.00047). Using Google Maps, we georeferenced households and identified them on a NBI map adapted from the 2010 demographic census. In neighborhoods with NBI > 9.7%, 51.2% of the households had a history of SSTI. When NBI was < 9.7%, the percentage fell to 31.1% (p = 0.0019). These results are suggestive of an association of SSTI acquired in the community with overcrowding and poverty. The presence of CaMRSA in community SSTIs should be suspected. Vancomycin or clindamycin prophylaxis could be considered when cesarean deliveries are performed in women from areas with high NBI or with a history of SSTI.


Subject(s)
Humans , Male , Female , Pregnancy , Staphylococcal Infections/epidemiology , Crowding , Skin Diseases, Bacterial/epidemiology , Soft Tissue Infections/epidemiology , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Argentina/epidemiology , Poverty , Staphylococcal Infections/microbiology , Staphylococcal Infections/transmission , Cesarean Section/adverse effects , Family Characteristics , Prospective Studies , Community-Acquired Infections/microbiology , Community-Acquired Infections/transmission , Community-Acquired Infections/epidemiology
11.
Rev. Soc. Bras. Med. Trop ; 50(6): 833-838, Nov.-Dec. 2017. tab, graf
Article in English | LILACS | ID: biblio-1041437

ABSTRACT

Abstract INTRODUCTION: Wounds can be colonized by methicillin-resistant Staphylococcus aureus (MRSA). METHODS: We evaluated the prevalence of S. aureus and MRSA in the wounds of patients treated at Basic Health Units in Brazil and identified risk factors associated with their presence. RESULTS: The prevalence rates of S. aureus and MRSA were 51.5% and 8.7%, respectively. There was a correlation between the presence of S. aureus in wounds and nostrils (p<0.01). A positive association was detected between S. aureus infection and previous benzylpenicillin use (p=0.02). No associations were observed for MRSA. CONCLUSIONS: Multidrug-resistant pathogens are present in primary healthcare settings in Brazil.


Subject(s)
Humans , Male , Female , Staphylococcal Infections/epidemiology , Staphylococcus aureus/isolation & purification , Wounds and Injuries/microbiology , Primary Health Care , Socioeconomic Factors , Staphylococcal Infections/diagnosis , Brazil/epidemiology , Chronic Disease , Prevalence , Cross-Sectional Studies , Risk Factors , Methicillin-Resistant Staphylococcus aureus/isolation & purification
12.
Rev. chil. infectol ; 34(5): 487-490, oct. 2017. tab
Article in Spanish | LILACS | ID: biblio-899746

ABSTRACT

Resumen Introducción: El principal microorganismo implicado en las infecciones de piel y tejidos blandos (IPTB) es Staphylococcus aureus, con incremento en las cepas resistentes a meticilina en los últimos años. Objetivo: Identificar la frecuencia de S. aureus resistente a meticilina (SARM) en IPTB en niños que consultaron a un hospital de cuarto nivel en la ciudad de Medellín. Métodos: Estudio descriptivo, retrospectivo, a partir de la revisión de historias clínicas. Se incluyeron pacientes menores de 18 años con IPTB causadas por S. aureus que no cumplieran con criterios de enfermedad invasora. Resultados: La prevalencia de SARM en esta población fue de 31%. El principal diagnóstico fue absceso cutáneo (68%), seguido por infección de sitio quirúrgico (15%) y celulitis no purulenta (6%). Tenían alguna co-morbilidad 85% de los pacientes. Todos los aislados fueron sensibles a rifampicina y cotrimoxazol. Ocho por ciento de los aislados fueron resistentes a clindamicina. Se encontró mayor prevalencia de SARM en lactantes comparado con los mayores de 2 años (60 vs 23%, p = 0,0109). Conclusión: Ante la alta prevalencia de SARM en IPTB se recomienda incluir en el tratamiento empírico antimicrobianos con cobertura para estas cepas, principalmente para lactantes.


Background: Skin and soft tissue infections (SSTI) are very common in children and Staphylococcus aureus is the main agent, with an increase of methicillin resistant strains (MRSA) in recent years. Aim: To identify the frequency of MRSA in skin and soft tissue infections (SSTI) in children from a high complex hospital in Medellin, Colombia. Methods: This is a descriptive, retrospective study, information was obtained from medical records. We included patients younger than 18 years with SSTI due to S. aureus who did not meet criteria for invasive disease. Results: The prevalence of MRSA in this population was 31%. The main diagnosis was cutaneous abscess (68%), followed by surgical site infection (15%) and non-purulent cellulitis (6%). Eighty five percent of the patients had at least 1 comorbidity. All isolates were sensitive to rifampicin and cotrimoxazole and 8% of the isolates were resistant to clindamycin. There was a higher prevalence of MRSA in patients under 2 years compared to older (60 vs 23%, p = 0,0109). Conclusion: In view of the high prevalence of MRSA in SSTI, empirical treatment with adequate coverage for MRSA is recommended, especially for patients under 2 years of age.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Staphylococcal Infections/epidemiology , Staphylococcus aureus/isolation & purification , Staphylococcal Skin Infections/epidemiology , Soft Tissue Infections/epidemiology , Skin/microbiology , Staphylococcal Infections/microbiology , Staphylococcal Infections/drug therapy , Staphylococcus aureus/drug effects , Staphylococcal Skin Infections/microbiology , Staphylococcal Skin Infections/drug therapy , Prevalence , Retrospective Studies , Methicillin Resistance/drug effects , Age Factors , Sex Distribution , Colombia/epidemiology , Soft Tissue Infections/microbiology , Soft Tissue Infections/drug therapy , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Methicillin-Resistant Staphylococcus aureus/drug effects , Hospitals , Anti-Bacterial Agents/therapeutic use
13.
Rev. Soc. Bras. Med. Trop ; 50(5): 680-684, Sept.-Oct. 2017. tab, graf
Article in English | LILACS | ID: biblio-1041427

ABSTRACT

Abstract INTRODUCTION: With the advancement of medicine and surgery, various types of medical devices have become part of treatment strategies. METHODS: Identification and antimicrobial sensitivity testing were done according to CLSI guidelines following standard microbiological practices. RESULTS: Urinary catheter infections (31%) were most frequent followed by central venous catheter (18%) and orthopedic implants (15%). Methicillin resistant Staphylococcus aureus (MRSA) was a major cause of device-related infection after Escherichia coli (21%); other pathogens were Klebsiella pneumoniae (14%), Pseudomonas spp. (10%), Acinetobacter spp. (8%) and Candida species (7%). None of MRSA was resistant to vancomycin (MIC ≥16µg/mL). Resistance rates were 98% and 97% for ofloxacin and ciprofloxacin, respectively. CONCLUSIONS Escherichia coli and MRSA are major pathogens of medical device-related infections.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Staphylococcal Infections/microbiology , Staphylococcal Infections/epidemiology , Prosthesis-Related Infections/microbiology , Prosthesis-Related Infections/epidemiology , Methicillin-Resistant Staphylococcus aureus/isolation & purification , Catheter-Related Infections/microbiology , Catheter-Related Infections/epidemiology , Pakistan/epidemiology , Time Factors , Candida/isolation & purification , Microbial Sensitivity Tests , Prevalence , Retrospective Studies , Risk Factors , Equipment and Supplies/microbiology , Gram-Negative Bacteria/isolation & purification , Middle Aged
14.
Rev. argent. microbiol ; 49(1): 24-31, mar. 2017. graf, tab
Article in Spanish | LILACS | ID: biblio-843180

ABSTRACT

Se realizó una revisión retrospectiva durante 12 años de las infecciones por Staphylococcus aureus en pacientes adultos (PA) y pediátricos (PP) asistidos en el Hospital Interzonal General de Agudos Evita de Lanús, para conocer la incidencia, los focos y el origen de la infección, y analizar el perfil de resistencia antimicrobiana. Se documentaron 2125 casos de infección en PA y 361 en PP. La incidencia de casos en PA descendió significativamente en el último trienio (χ²; p < 0,05); en los PP aumentó significativamente durante los últimos 5 años (χ²; p < 0,0001). En ambas poblaciones se detectó un aumento significativo en las infecciones de piel y estructuras asociadas (PEA), de bacteriemias a punto de partida de un foco en PEA y de infecciones por S. aureus de inicio en el hospital (χ²; p < 0,005). La meticilino-resistencia (SAMR) aumentó del 28 al 78% en PP; en PA se mantuvo alrededor del 50%, con reducción significativa de la resistencia acompañante a antimicrobianos no betalactámicos en los SAMR de ambas poblaciones. En S. aureus documentados de infecciones de inicio en la comunidad (SAMR-CO) del último trienio, el porcentaje de meticilino-resistencia resultó del 57% en PP y 37% en PA; en infecciones con inicio en el hospital fue del 43 y el 63%, respectivamente. Si bien demostramos que S. aureus continúa siendo un patógeno asociado al ámbito nosocomial, hubo un aumento de infecciones por SAMR-CO, con compromiso en PEA en ambas poblaciones.


A twelve-year retrospective review of Staphylococcus aureus infections in adult and pediatric patients (AP and PP respectively) assisted in the Hospital Interzonal General de Agudos Evita in Lanús was performed to determine the incidence, foci of infection, the source of infection and to analyze the profile of antimicrobial resistance. An amount of 2125 cases of infection in AP and 361 in PP were documented. The incidence in AP decreased significantly in the last three years (χi²; p < 0.05); in PP it increased significantly during the last five years (χ²; p < 0.0001). In both populations was detected a notable increase in skin infections and associated structures (PEA) in bacteremia to the starting point of a focus on PEA, and in total S. aureus infections of hospital-onset (χ²; p < 0.005). Methicillin-resistance (MRSA) increased from 28 to 78% in PP; in AP it remained around 50%, with significant reduction in accompanying antimicrobial resistance to non-β-lactams in both groups of MRSA. In S. aureus documented from community onset infections (CO-MRSA) in the last three years, the percentage of methicillin-resistance was 57% in PP and 37% in AP; in hospital-onset infections it was 43% and 63% respectively. Although data showed that S. aureus remains a pathogen associated with the hospital-onset, there was an increase of CO-MRSA infections with predominance in PEA in both populations.


Subject(s)
Humans , Male , Female , Staphylococcal Infections/etiology , Staphylococcal Infections/epidemiology , Cross Infection/epidemiology , Staphylococcus aureus/drug effects , Cross Infection/drug therapy , Incidence , Methicillin-Resistant Staphylococcus aureus
15.
Pesqui. vet. bras ; 36(12): 1178-1180, Dec. 2016.
Article in English | LILACS, VETINDEX | ID: biblio-842031

ABSTRACT

In order to assess the prevalence of Methicillin-resistant Staphylococcus pseudintermedius from skin and nostrils of dogs with pyoderma, to determine its in vitro susceptibility, and to correlate these data with the presence of the mecA gene, 43 dogs were selected. Samples were collected from secretion of their skin lesions and right nostril, cultured, and analyzed for phenotypic and genotypic characteristics of the bacteria studied. In 62 samples (91%) the microorganism was classified as S. pseudintermedius. The rate of resistance against antibiotics ranged from 7% (amikacin; 4/62) to 77% (sulfamethoxazole + trimethoprim; 48/62). Resistance against oxacillin was found in 34% of the samples (21/62). Twenty-five samples (37%) were strains that carried the mecA gene. A significant correlation (P<0.01) was found between presence of the mecA gene and oxacillin resistance. Seventeen dogs were mecA gene carriers, and 8 (47%) of them had the gene in the skin lesions and nostril. A significant correlation (P<0.01) was also observed between the presence of mecA gene in the skin lesions and nostrils. Oxacillin resistance in vitro can be safely used to indicate the presence of mecA gene in MRSP samples. The nostrils can be a reservoir of MRSP in dogs.(AU)


Para acessar a prevalência de MRSP na pele e nas narinas de cães com piodermite superficial, determinar a suscetibilidade in vitro, e correlacionar estes dados com a presença do gene mecA, foram selecionados 43 cães. Amostras de lesões de pele e narinas foram coletadas, cultivadas, e analisadas fenotipica e genotipicamente. Em 62 amostras (91%), os microrganismos foram classificados como Staphylococcus pseudintermedius. A taxa de resistência a antibióticos variou entre 7% (amicacina; 4/62) e 77% (sulfamethoxazol + trimetoprim; 48/62). Resistência a oxacilina foi observada em 34% das amostras (21/62). Vinte e cinco amostras (37%), eram cepas portadoras do gene mecA. Correlação significativa (P<0,01) foi observada entre a presença do gene mecA e a resistência à oxacilina. Considerando os cães, 17 eram portadores de cepas com gene mecA e 8(47%) delas carreavam este gene nas amostras de lesão de pele e nas narinas. Correlação significativa (P>0,01) foi observada entre a presença do gene mecA nas lesões de pele e nas narinas. Sendo assim, resistência à oxacilina in vitro pode ser aferida com segurança para indicar a presença do gene mecA em amostras de MRSP, e as narinas podem constituir em um reservatório dos microorganismos em cães.(AU)


Subject(s)
Animals , Dogs , Methicillin Resistance , Oxacillin/analysis , Pyoderma/veterinary , Staphylococcal Infections/epidemiology , Staphylococcus , Anti-Bacterial Agents , In Vitro Techniques/veterinary
16.
Clinics ; 71(12): 715-719, Dec. 2016. tab, graf
Article in English | LILACS | ID: biblio-840025

ABSTRACT

OBJECTIVES: To clinically and epidemiologically characterize a population diagnosed with and treated for septic arthritis of the knee, to evaluate the treatment results and to analyze the differences between patients with positive and negative culture results, patients with Gram-positive and Gram-negative bacterial isolates and patients with S. aureus- and non-S. aureus-related infections. METHODS: One hundred and five patients with septic knee arthritis were included in this study. The clinical and epidemiological data were evaluated. Statistical analysis was performed to compare patients with and without an isolated causative agent, patients with Gram-positive and Gram-negative pathogens and patients with S. aureus-related and non S. aureus-related infections. RESULTS: Causative agents were isolated in 81 patients. Gram-positive bacteria were isolated in 65 patients and Gram-negative bacteria were isolated in 16 patients. The most commonly isolated bacterium was S. aureus. Comparing cases with an isolated pathogen to cases without an isolated pathogen, no differences between the studied variables were found except for the longer hospital stays of patients in whom an etiological agent was identified. When comparing Gram-positive bacteria with Gram-negative bacteria, patients with Gram-positive-related infections exhibited higher leukocyte counts. Patients with S. aureus-related infections were more frequently associated with healthcare-related environmental encounters. CONCLUSION: S. aureus is the most common pathogen of septic knee arthritis. Major differences were not observed between infections with isolated and non-isolated pathogens and between infections with Gram-positive and Gram-negative bacteria. S. aureus infections were more likely to be associated with a prior healthcare environment exposure.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Arthritis, Infectious/microbiology , Gram-Negative Bacteria/isolation & purification , Gram-Positive Bacteria/isolation & purification , Knee Joint/microbiology , Arthritis, Infectious/epidemiology , Brazil , C-Reactive Protein/analysis , Knee/microbiology , Retrospective Studies , Sex Distribution , Staphylococcal Infections/epidemiology , Staphylococcus aureus/isolation & purification
18.
Rev. chil. ortop. traumatol ; 57(2): 42-46, mayo-ago. 2016. tab
Article in Spanish | LILACS | ID: biblio-909696

ABSTRACT

INTRODUCCIÓN: Las infecciones osteoarticulares son un desafío frecuente en la práctica traumatológica diaria. En Chile y en los distintos hospitales de la región de Valparaíso son escasos los trabajos con relación al tema, lo que es fundamental para optimizar el tratamiento, tanto quirúrgico como médico, de estas infecciones. OBJETIVOS: Describir las infecciones osteoarticulares del Hospital del IST de Viña del Mar durante el periodo 2012-2013. MATERIALES Y MÉTODO: Trabajo descriptivo retrospectivo de una serie de casos. Se revisaron las fichas clínicas de los pacientes que cursaron con alguna infección osteoarticular y se obtuvieron los datos demográficos y clínicos de cada paciente. RESULTADOS: Treinta pacientes fueron incluidos. Dieciséis (53,3%) fueron hombres con un promedio de edad de 38,5años. El 50% correspondieron a infecciones asociadas a la atención de salud. Las principales infecciones fueron asociadas a material de osteosíntesis. El agente más frecuente fue el Staphylococcus aureus meticilinosensible (SAMS). En la mayoría de los casos se realizó aseo quirúrgico, toma de cultivos e inicio de antibióticos con ceftriaxona más clindamicina. CONCLUSIONES: Las infecciones osteoarticulares ocurrieron principalmente en hombres jóvenes, fueron infecciones asociadas a material de osteosíntesis y producidas por SAMS.


INTRODUCTION: Osteoarticular infections are a common challenge in everyday trauma practice. In Chile, and in different hospitals in the region of Valparaiso, there are few studies on the issue, which is essential to optimise both surgical and medical treatment of these infections. OBJECTIVES: To describe the osteoarticular infections in the Hospital del Instituto de Seguridad del Trabajador (IST) of Viña del Mar during the 2012-2013 period. MATERIALS AND METHODS: A retrospective descriptive study was performed on a series of cases. A review was made of the medical records of patients with any osteoarticular infection. Demographic and clinical data were obtained from each patient. RESULTS: Of the total of 30 patients included, 16 (53.3%) were male with a mean age of 38.5 years. Half (50%) of the infections were associated with health care. Major infections were associated with osteosynthesis material. The most frequent agent was Methicillin Susceptible Staphylococcus aureus (MSSA). In most cases surgical cleanliness, taking of microbiological cultures, and antibiotic treatment with ceftriaxone plus clindamycin, was performed. CONCLUSIONS: Osteoarticular infections occurred mainly in young men, were infections associated to osteosynthesis material, and caused by MSSA.


Subject(s)
Humans , Male , Female , Adult , Bone Diseases, Infectious/microbiology , Arthritis, Infectious/microbiology , Staphylococcal Infections/surgery , Staphylococcal Infections/complications , Staphylococcal Infections/drug therapy , Staphylococcal Infections/epidemiology , Staphylococcus aureus/isolation & purification , Bone Diseases, Infectious/surgery , Bone Diseases, Infectious/drug therapy , Bone Diseases, Infectious/epidemiology , Arthritis, Infectious/surgery , Arthritis, Infectious/drug therapy , Arthritis, Infectious/epidemiology , Retrospective Studies , Prosthesis-Related Infections/microbiology , Prosthesis-Related Infections/epidemiology , Joint Diseases/microbiology , Joint Prosthesis/microbiology , Anti-Bacterial Agents/therapeutic use
19.
Rev. chil. infectol ; 33(3): 322-330, jun. 2016. ilus
Article in Spanish | LILACS | ID: lil-791027

ABSTRACT

Introducción: La espondilodiscitis (ED) implica prolongados períodos de hospitalización, de latencia diagnóstica y riesgo de complicaciones a largo plazo. No existen publicaciones recientes en Chile al respecto. Objetivos: Caracterizar un grupo de pacientes con ED. Pacientes y Métodos: Serie clínica, que incluyó pacientes en un período de ocho años. Resultados: 37 pacientes, 37,8% mujeres y 62,2% hombres, con promedio etario 66,8 años; 64,9% adultos mayores, 35,1% diabéticos y 21,6% con co-morbilidad urológica. Los principales síntomas fueron dolor y fiebre. 89,2% tuvo elevación de VHS. 86,5% contó con resonancia magnética, que siempre fue confirmatoria, siendo la columna lumbar la localización más frecuente (43,2%). Se identificó etiología en 28/37 pacientes: en 71,4% cocáceas grampositivas (Staphylococcus aureus predominantemente), sólo en 10,7% M. tuberculosis. Staphylococcus aureus estuvo asociado a co-morbilidades médicas en forma significativa (p < 0,05) y el grupo de bacilos gramnegativos a historia hepatobiliar y/o intestinal (p < 0,05). El método de mayor rendimiento fue el cultivo obtenido por punción quirúrgica. El tratamiento antimicrobiano fue indicado en promedio por 63,8 días (IQR 53-72), con reacciones adversas en 18,9%. La estadía hospitalaria fue 38,9 días promedio, no existiendo fallecidos durante este período. 18,9% presentó secuelas motoras. Discusión: La mayoría de pacientes con ED correspondió a adultos mayores, siendo S. aureus la principal etiología. Hubo una baja frecuencia de M. tuberculosis. Resultó considerable la magnitud de efectos adversos asociados a la terapia antimicrobiana y las complicaciones neurológicas.


Background: Spondylodiscitis (SD) involves long periods of hospitalization, diagnostic latency and risk of long-term complications. No updated series are available in Chile and a change in demographic features and etiology is suspected. Aim: To characterize a group of patients with SD. Patients and Methods: Clinical series including patients over an 8 year period. Results: We identified 37 patients; 37.8% women and 62.2% men (mean age 66.8 years); 64.9% were elderly; 35.1% had diabetes and 21.6% urological comorbidity. Main symptoms were pain and fever. Erythrocyte sedimentation rate was elevated in 89.2%, and 86.5% patients had MRI, which was always confirmatory. Lumbar spine was the most common site of infection (43.2%). Etiology was identified in 28/37 patients: 71.4% yielded grampositive cocci (Staphylococcus aureus predominantly), Mycobacterium tuberculosis was identified in only 10.7%. Staphylococcus aureus was associated to medical comorbidities (p < 0,05) and gramnegative bacilli to hepatobiliar or intestinal symptoms (p < 0,05). Culture obtained by a surgical procedure had the highest yield. The average duration of antibiotic therapy was 63.8 days (IQR 53-72). Treatment-related side effects were detected in 18.9% of patients. The average hospital stay was 38.9 days. No deaths occurred during hospitalization. Motor sequelae were present in 18.9% of this series. Discussion: Most patients with SD were older adults. Staphylococcus aureus was predominant and M. tuberculosis was uncommon. Antibiotic side effects were relevant as well as the neurological complications.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Discitis/microbiology , Discitis/epidemiology , Osteomyelitis/microbiology , Osteomyelitis/epidemiology , Spinal Diseases/microbiology , Spinal Diseases/epidemiology , Staphylococcal Infections/microbiology , Staphylococcal Infections/epidemiology , Staphylococcus aureus/isolation & purification , Discitis/therapy , Comorbidity , Chile/epidemiology , Retrospective Studies , Risk Factors , Treatment Outcome , Sex Distribution , Gram-Negative Aerobic Bacteria/isolation & purification , Gram-Positive Bacteria/isolation & purification , Hospitals, General/statistics & numerical data
20.
Acta ortop. mex ; 30(3): 123-131, may.-jun. 2016. tab
Article in Spanish | LILACS | ID: biblio-837771

ABSTRACT

Resumen: Introducción: La infección de sitio operatorio (ISO) es la infección nosocomial más común y es un proceso asociado a múltiples factores, los cuales en conjunto generan una alteración que afecta directamente el bienestar del paciente. Material y métodos: Estudio de corte transversal realizado en un período de un año, el tamaño de la muestra se estableció por el total de pacientes que cumplían los criterios de inclusión; se efectuó doble tabulación de los pacientes en el programa de Excel 2013 y se analizaron los datos en Stata versión 11. Resultados: La edad promedio fue de 44.3 ± 18.8 años y la relación hombre:mujer fue 1.7:1. De las características clínicas, los miembros inferiores fueron los más afectados y 21.9% de los casos afectó el fémur. Se halló una prevalencia de 6.6%, siendo la infección profunda la más frecuente; Staphylococcus aureus se cultivó en 38.5%, de los cuales 40% fue meticilino sensible. Conclusión: La prevalencia de ISO en pacientes con fracturas cerradas en el HUS fue de 6.6%, dato elevado comparado con la literatura. Los hallazgos de este estudio permitieron establecer que la hemoglobina por debajo de 10 g/dl, la realización de transfusión, la reintervención y el riesgo quirúrgico ASA se asociaron de manera estadística a la ISO.


Abstract: Introduction: Surgical site infection (ISO) is the most common nosocomial infection and is a process associated with multiple factors, which together generate a condition that directly affects the welfare of the patient. Material and methods: Cross-sectional study, conducted over 1 year period, the sample size was established for all patients who met the inclusion criteria. An instrument takes the variables; double tabulation of patients is performed in Excel 2013 and data are analyzed in Stata version 11. Results: The average age was 44.3 ± 18.8 years and the male: female ratio is 1.7:1. Clinical features, lower limbs are the most affected and 21.9 % of cases affect the femur. A prevalence of 6.6 % was found, being the most common deep infection classification. Staphylococcus aureus was cultured in 38.5% of which 40% were methicillin sensible. Conclusion: ISO prevalence in patients with closed fractures in HUS is 6.6% higher compared with literature data. The findings of this study it was established that hemoglobin below 10 g/dl, transfusion, reoperation and surgical risk ASA were associated statistically with ISO.


Subject(s)
Humans , Male , Female , Adult , Staphylococcal Infections/etiology , Staphylococcal Infections/epidemiology , Surgical Wound Infection , Fractures, Closed/complications , Fractures, Closed/microbiology , Prevalence , Cross-Sectional Studies , Risk Factors , Middle Aged
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