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1.
Article in Spanish | LILACS, CUMED | ID: biblio-1536343

ABSTRACT

Introducción: El hemangioma cavernoso es una de las neoplasias benignas más frecuentes en la infancia. Objetivo: Describir el caso de un hemangioma cavernoso en edad pediátrica. Caso clínico: Lactante femenina de 6 meses de edad, de procedencia urbana, cuyo nacimiento tuvo lugar en el Hospital Materno Fe del Valle Ramos, del municipio Manzanillo. Al nacer se observa una lesión en forma placa eritematosa violácea infiltrada de ± 10 cm, de borde definido, de superficie liza, con aumento de temperatura al tacto, que se extendía desde la parte medial anterior y posterior hasta la superior de la pierna del miembro inferior izquierdo. Se decidió interconsultar con el Servicio de Angiología, el cual diagnostica la lesión como hemangioma cavernoso. Conclusiones: Se corroboró que el hemangioma cavernoso es una entidad frecuente en la infancia, su diagnóstico y tratamiento oportunos son altamente beneficiosos para la mejoría y la cura, por lo que se impone la realización de un correcto y exhaustivo examen físico, de lo que se deriva también la prevención de complicaciones a corto, mediano y largo plazo(AU)


Introduction: Cavernous hemangioma is one of the most frequent benign neoplasms in childhood. Objective: To describe the case of a cavernous hemangioma at pediatric age. Clinical case: A 6-month-old female infant of urban origin was born at Hospital Materno Fe del Valle Ramos, Manzanillo Municipality, Granma Province. At birth, a violaceous erythematous plaque-like infiltrated lesion was observed, of approximately 10 cm, with a defined border, smooth surface, increased temperature at hand contact, extending from the anterior and posterior medial part to the upper leg of the left lower limb. It was decided to do an interconsultation with the angiology service, which diagnosed the lesion as a cavernous hemangioma. Conclusions: Cavernous hemangioma was corroborated to be a frequent entity in childhood, whose timely diagnosis and treatment are highly beneficial for improvement and cure, so it extremely necessary to carry out a correct and exhaustive physical examination, also deriving the prevention of complications in the short, medium and long terms(AU)


Subject(s)
Humans , Female , Infant , Urinary Tract Infections/drug therapy , Ceftriaxone/therapeutic use , Hemangioma, Cavernous/epidemiology , Neoplasms/diagnosis
2.
Arq. ciências saúde UNIPAR ; 26(3): 1325-1342, set-dez. 2022.
Article in Portuguese | LILACS | ID: biblio-1402281

ABSTRACT

A infecção do trato urinário (ITU) nada mais é do que o acometimento das vias urinárias por microrganismo. Entre as infecções hospitalares de maior incidência está a infecção do trato urinário, acometendo mais mulheres do que homens. Uma das possíveis causas dessa infecção, em pacientes na unidade de terapia intensiva (UTI), é o uso de cateter vesical. Seu tratamento inadequado pode ocasionar uma pielonefrite, podendo adentrar à circulação sanguínea, gerando uma infecção sistêmica e levar o paciente a óbito. A resistência antimicrobiana é uma das principais dificuldades encontrada em UTI sendo considerado um problema de saúde pública. O objetivo deste trabalho foi realizar um breve relato, baseado na literatura, sobre a resistência antimicrobiana na infecção urinária em unidade de terapia intensiva adulta. Em ambientes hospitalares o principal microrganismo causador de ITU é Escherichia coli, sendo 55,5% das culturas positivas estão associadas a procedimentos invasivos, como as sondas vesicais de demora, como consequência este é o microrganismo que mais apresenta resistência aos antimicrobianos utilizados como a ampicilina, trimetoprima e ciprofloxacino. O uso indiscriminado de antibióticos deixa em evidência a necessidade de análise criteriosa da real necessidade de qual antimicrobianos usar, tempo de uso e forma correta de administração. Portanto é necessária a ação dos profissionais de saúde frente a atenção ao paciente, desde a higiene das mãos, uso do cateter, quando necessário observar a real necessidade do uso do antimicrobianos e que esse seja feito após cultura e antibiograma.


Urinary tract infection (UTI) is nothing more than the involvement of the urinary tract by a microorganism. Among the hospital infections with the highest incidence is urinary tract infections, affecting more women than men. One of the possible causes of this infection in patients in the intensive care unit (ICU) is the use of a bladder catheter. Its inadequate treatment can cause pyelonephritis, which can enter the bloodstream, generating a systemic infection and leading the patient to death. Antimicrobial resistance is one of the main difficulties encountered in ICUs and is considered a public health problem. The objective of this study was to present a brief report, based on the literature, on antimicrobial resistance in urinary tract infections in an adult intensive care unit. In hospital environments, the main microorganism that causes UTI is Escherichia coli, and 55.5% of positive cultures are associated with invasive procedures, such as indwelling urinary catheters, as a consequence, this is the microorganism that is most resistant to antimicrobials used, such as ampicillin, trimethoprim and ciprofloxacin. The indiscriminate use of antibiotics highlights the need for a careful analysis of the real need for which antimicrobials to use, time of use, and correct form of administration. Therefore, it is necessary for the action of health professionals in the care of the patient, from the hygiene of the professional to, the use of the catheter, when necessary to observe the real need for the use of antimicrobials and that this is done after culture and antibiogram.


La infección del tracto urinario (ITU) no es más que la afectación de las vías urinarias por un microorganismo. Entre las infecciones hospitalarias con mayor incidencia se encuentra la infección del tracto urinario, que afecta más a mujeres que a hombres. Una de las posibles causas de esta infección en pacientes en la unidad de cuidados intensivos (UCI) es el uso de una sonda vesical. Su tratamiento inadecuado puede causar pielonefritis, la cual puede ingresar al torrente sanguíneo, generando una infección sistémica y llevando al paciente a la muerte. La resistencia a los antimicrobianos es una de las principales dificultades encontradas en las UCI y se considera un problema de salud pública. El objetivo de este estudio fue presentar un breve informe, basado en la literatura, sobre la resistencia antimicrobiana en infecciones del tracto urinario en una unidad de cuidados intensivos de adultos. En ambientes hospitalarios, el principal microorganismo causante de ITU es Escherichia coli, y el 55,5% de los cultivos positivos están asociados a procedimientos invasivos, como sondas vesicales permanentes, por lo que este es el microorganismo más resistente a los antimicrobianos utilizados, como la ampicilina. ., trimetoprima y ciprofloxacino. El uso indiscriminado de antibióticos pone de relieve la necesidad de un análisis cuidadoso de la necesidad real de qué antimicrobianos utilizar, el momento de uso y la forma correcta de administración. Por lo tanto, es necesaria la actuación de los profesionales de la salud en el cuidado del paciente, desde la higiene del profesional, uso del catéter, cuando sea necesario observar la necesidad real del uso de antimicrobianos y que este se realice previo cultivo y antibiograma.


Subject(s)
Humans , Female , Urinary Tract Infections/complications , Urinary Tract Infections/mortality , Urinary Tract Infections/prevention & control , Urinary Tract Infections/drug therapy , Drug Resistance, Microbial/drug effects , Urinary Tract , Women , Ciprofloxacin/therapeutic use , Cross Infection/complications , Cross Infection/transmission , Escherichia coli/pathogenicity , Catheters/microbiology , Hand Hygiene , Ampicillin/therapeutic use , Intensive Care Units , Anti-Infective Agents/therapeutic use , Anti-Bacterial Agents/therapeutic use
3.
Rev. argent. microbiol ; 54(2): 120-124, jun. 2022. tab
Article in English | LILACS, UY-BNMED, BNUY | ID: biblio-1407180

ABSTRACT

Fosfomycin tromethamol (FT) was reintroduced as an option for the treatment of low urinary tract infection (UTI) in children. In this study, we described the antibiotic sensitivity and mechanisms of resistance to fosfomycin in isolates from children older than 6 years with UTI. Urine culture and antibiotic susceptibility study were performed. In fosfomycin resistant strains, PCR for fos, blaCTX-M was performed followed by classification by phylogenetic group and sequencetyping. Escherichia coli was the most frequent etiological agent (89.2%). The susceptibility percentages were: fosfomycin 97.9%; amoxicillin-clavulanate 92.7%; cefuroxime and ceftriaxone 99%; nitrofurantoin 94.4%. An E. coli strain (ST69, phylogenetic group D) was resistant to fosfomycin (MIC 256mg/l) and carried the blaCTX-M-14 and fosA3 genes in a 45kb IncN-type plasmid.


La fosfomicina-trometamol (FT) se reintrodujo como una opción para el tratamiento de la infección del tracto urinario (ITU) baja en niños. En este estudio describimos la sensibilidad antibiótica y los mecanismos de resistencia a FT en aislamientos de niños mayores de 6 anos con ITU. Se realizaron urocultivos y estudios de sensibilidad antibiótica. En las cepas resistentes a fosfomicina se realizó la técnica de PCR para fos, blaCTX-M, y su identificación según su grupo filogenéticoy secuenciotipo. Escherichiacoli fue el agente etiológico más frecuente (89,2%). Los porcentajes de sensibilidad fueron: fosfomicina 97,9%; amoxicilina-clavulánico 92,7%; cefurox-ima y ceftriaxona 99%; nitrofurantoína 94,9%. Una cepa de E. coli (ST69, grupo filogenético D) fue resistente a fosfomicina (CIM 256mg/l) y portaba los genes blaCTX-M-14 y fosA3 en un plás-mido de 45 kb del tipo IncN. Este es el primer reporte de E. coli ST69 con blaCTX-M-14/fosA3 de origen humano.


Subject(s)
Humans , Child , Urinary Tract Infections/drug therapy , Escherichia coli Infections/drug therapy , Escherichia coli Infections/epidemiology , Fosfomycin/therapeutic use , Fosfomycin/pharmacology , Phylogeny , beta-Lactamases/genetics , Microbial Sensitivity Tests , Drug Resistance, Bacterial , Escherichia coli/genetics , Anti-Bacterial Agents/pharmacology
4.
Rev. chil. infectol ; 39(2): 174-183, abr. 2022. tab
Article in Spanish | LILACS | ID: biblio-1388355

ABSTRACT

Resumen La infección del tracto urinario (ITU) es una de las infecciones bacterianas más frecuentes en la infancia. Un adecuado diagnóstico es esencial para poder realizar un tratamiento racional, eficiente y eficaz; sin embargo, existe gran heterogeneidad en los métodos diagnósticos, específicamente en el estudio de la susceptibilidad antimicrobiana. El objetivo de estas recomendaciones es entregar herramientas para uniformar los criterios diagnósticos, el estudio de susceptibilidad bacteriana in vitro y el tratamiento antimicrobiano de la ITU en la población pediátrica, con un enfoque de uso racional de los antimicrobianos. En esta primera parte, se presentan las recomendaciones en cuanto a cómo obtener una adecuada muestra de orina, el diagnóstico de laboratorio incluyendo puntos de corte -unidades formadoras de colonias/mL de orina-, además de consideraciones microbiológicas para el estudio de susceptibilidad y finalmente, el manejo de la ITU en pediatría. En la segunda parte se detalla el tratamiento antimicrobiano de sus complicaciones, el manejo de ITU en situaciones especiales y consideraciones farmacocinéticas y farmacodinámicas de los antimicrobianos a indicar en ITU.


Abstract The urinary tract infection (UTI) is one of the most common bacterial infections in childhood. An adequate diagnosis is essential to be able to carry out a rational, efficient and effective treatment, however, there great heterogeneity in diagnostic methods, specifically in the study of antimicrobial susceptibility. The aim of these recommendations is to provide tools to homogenize the diagnosis criteria, susceptibility study and antimicrobial treatment of urinary tract infection in the pediatric population, with a rational use of antibiotics approach. In the first part, the recommendations regarding diagnosis are presented, such as sampling and cut-off points, as well as microbiological considerations for susceptibility study and management of UTI in pediatrics. The second part details the management of complications, UTI in special situations, and pharmacokinetic and pharmacodynamic considerations of antimicrobials to be prescribed in UTI.


Subject(s)
Humans , Child , Pediatrics , Bacterial Infections/drug therapy , Urinary Tract Infections/diagnosis , Urinary Tract Infections/drug therapy , Urinary Tract Infections/epidemiology , Chile , Anti-Bacterial Agents/therapeutic use
5.
Article in English | LILACS, CUMED | ID: biblio-1408679

ABSTRACT

Introducción: Las infecciones del tracto urinario causadas por bacterias gramnegativas resistentes a los antibióticos son una preocupación creciente debido a las limitadas opciones terapéuticas. Objetivo: Analizar la tendencia de resistencia a los antibióticos en Escherichia coli resistente a la ciprofloxacina aislada de la infección del tracto urinario adquirida en la comunidad. Métodos: Estudio de series de tiempo que analiza registros de urocultivos positivos para E. coli resistente a ciprofloxacina en personas de ≥18 años de 2011 a 2017. Las tendencias en los patrones de resistencia a los antibióticos se obtuvieron mediante la regresión lineal generalizada de Prais-Winsten. El cambio porcentual anual (APC) y el intervalo de confianza del 95 por ciento (IC 95 por ciento) se calcularon a partir del coeficiente de análisis de regresión β1 y el error estándar (SE). Los valores de p < 0,05 se consideraron estadísticamente significativos. Resultados: De los datos analizados, 3363 (26,1 por ciento) fueron positivos para E. coli resistente a la ciprofloxacina. El aumento de E. coli resistente a la ciprofloxacina fue del 45,3 por ciento. Las mujeres sufrieron más infección por E. coli sensible a la ciprofloxacina (75,5 por ciento), pero los hombres tuvieron una mayor probabilidad de infectarse con E. coli resistente a la ciprofloxacina [2,132 (1,891-2,402)]. El aumento de la resistencia fue mayor para la nitrofurantoína (<0,001) y la ceftriaxona (<0,001). La prevalencia de resistencia fue alta para nitrofurantoína, norfloxacina, ácido nalidíxico, amoxicilina/clavulanato, ceftriaxona y tobramicina. A excepción de la gentamicina, que presentó una tendencia a la baja en la resistencia, los otros antimicrobianos analizados no mostraron tendencias en la resistencia a los antibióticos. Conclusiones: Hubo un aumento promedio en la resistencia a los principales antibióticos utilizados para tratar la infecciones del tracto urinario adquirida en la comunidad. Entre los antibióticos probados, solo la gentamicina mostró una tendencia a la baja en la resistencia. Estos resultados son importantes para dirigir la elección de los antimicrobianos para el tratamiento empírico de la infección urinaria adquirida en la comunidad(AU)


Introduction: Urinary tract infections caused by antibiotic-resistant Gram-negative bacteria are a growing concern due to limited therapeutic options. Objective: To analyze the antibiotic resistance trend in ciprofloxacin-resistant Escherichia coli isolated from community-acquired urinary tract infection. Methods: Time series study analyzing records of urine cultures positive for ciprofloxacin-resistant E. coli in persons aged ≥18 years from 2011 to 2017. The trends in antibiotic resistance patterns were obtained using the Prais-Winsten generalized linear regression. Annual percent change (APC) and 95 percent confidence interval (CI 95 percent) were calculated from the regression analysis coefficient β1 and standard error (SE). Values of p<0.05 were considered statistically significant. Results: From the analyzed data, 3 363 (26.1 percent) were positive for ciprofloxacin-resistant E. coli. The increase in ciprofloxacin-resistant E. coli was 45.3 percent. Females suffered more infection by ciprofloxacin-sensitive E. coli (75.5 percent), but males had a higher chance of being infected with ciprofloxacin-resistant E. coli. [2.132 (1.891- 2.402)]. Increase in resistance was highest for nitrofurantoin (<0.001) and ceftriaxone (<0.001). Prevalence of resistance was high for nitrofurantoin, norfloxacin, nalidixic acid, amoxicillin/clavulanate, ceftriaxone, and tobramycin. Except for gentamicin, which presented a downward trend in resistance, the other antimicrobials analyzed displayed no trends in antibiotic resistance. Conclusions: There was an average increase in resistance to the main antibiotics used to treat community-acquired UTI. Among the antibiotics tested, only gentamicin displayed a downward trend in resistance. These results are important to direct the choice of antimicrobials for the empirical treatment of community-acquired UTI(AU)


Subject(s)
Humans , Male , Female , Urinary Tract Infections/drug therapy , Community-Acquired Infections/diagnosis , Escherichia coli Infections/drug therapy , Anti-Bacterial Agents/therapeutic use
6.
Femina ; 50(9): 572-576, 2022.
Article in Portuguese | LILACS | ID: biblio-1397895

ABSTRACT

A infecção do trato urinário (ITU) é a doença bacteriana mais comum no sexo feminino, e cerca de 25% a 30% das mulheres apresentam ITUs recorrentes ao longo da vida. Os antibióticos são muito utilizados para o tratamento e prevenção dessas infecções. Entretanto, o uso excessivo e indevido desses medicamentos, além dos efeitos adversos, está relacionado ao surgimento de uropatógenos multirresistentes. Há um interesse crescente na comunidade científica para encontrar alternativas ao uso de antibióticos para tratamento e/ou prevenção das infecções bacterianas. Esta revisão tem por objetivo discutir algumas dessas alternativas.(AU)


Urinary tract infection (UTI) is the most common bacterial disease in females, and about 25% to 30% of women experience recurrent UTIs throughout their lives. Antibiotics are widely used standard for treating and preventing these infections. However, the excessive and improper use of these drugs, in addition to the adverse effects, is related to the emergence of multidrug-resistant uropathogens. There is a growing interest in the scientific community to find alternatives to the use of antibiotics for the treatment and/or prevention of bacterial infections. This review aims to discuss some of these alternatives.(AU)


Subject(s)
Humans , Female , Urinary Tract Infections/drug therapy , Urinary Tract Infections/therapy , Complementary Therapies , Reinfection/therapy , Adjuvants, Immunologic , Probiotics/therapeutic use , Vaccinium macrocarpon , Drinking , Estrogens/therapeutic use , Fluid Therapy , Anti-Bacterial Agents/therapeutic use
7.
Bol. malariol. salud ambient ; 61(4): 633-641, dic. 2021. tab, graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1395694

ABSTRACT

La resistencia de antibióticos puede llegar a causar una amplia morbilidad y complicaciones. Objetivo: Determinar el perfil de resistencia antimicrobiana de Escherichia Coli y de Staphylococcus Saprophyticus, en pacientes con infección urinaria hospitalizados en el servicio de Medicina Interna del Hospital Municipal Los Olivos. Métodos: Estudio descriptivo, retrospectivo de corte transversal. Se realizó en el servicio de Medicina Interna del Hospital Municipal los Olivos (HMLO). Participantes: historia clínica de pacientes hospitalizados con infección urinaria en el servicio de Medicina Interna. Intervenciones: Según los criterios de inclusión y exclusión se obtuvieron, 96 historias clínicas (HC) del año 2013. Se utilizó un instrumento de recolección validado. Se realizó el análisis descriptivo con software estadístico STATA versión 25. Resultados: De las 96 HC, la edad promedio fue 55,04 años, los agentes microbianos más frecuentes fueron: la Escherichia coli con 85,3%, Staphylococcus saprophyticus 4.2% y Klebsiella pneumoniae 3,1%. La prevalencia de productores de betalactamasa espectro extendido (BLEE) fue 10,4%. Los antibióticos más resistentes fueron: trimetoprim/sulfametoxazol 89,6%, ampicilina 86%, piperacilina 84,6%, tetraciclina 79,2% y ciprofloxacino 70,8%. Los antibióticos más sensibles fueron: amikacina 100%, imipenem 100%, ertapenem 98%, meropenem 96% y piperacilina/tazobactam 96%. Conclusión: El uropatógeno más frecuente en pacientes con ITU hospitalizados fue la E. coli. Los antibióticos que presentaron resistencia a la E. coli fueron: trimetoprim/sulfametoxazol, ampicilina, piperacilina, tetraciclina y ciprofloxacino, y para el S. Saprophyticus fueron: amoxicilina/ ácido clavulánico, trimetoprim/sulfametoxazol, ceftriaxona y ciprofloxacino(AU)


Resistance to antibiotics may actually cause extensive morbidity and complications. Objective: To determine the antimicrobial resistance profile of Escherichia coli and Staphylococcus saprophyticus, in patients with urinary infection hospitalized in the Internal Medicine service of the Los Olivos Municipal Hospital. Methods: Descriptive, retrospective cross-sectional study. It was carried out in the Internal Medicine service of the Los Olivos Municipal Hospital (HMLO). Participants: clinical history of hospitalized patients with urinary infection in the Internal Medicine service. Interventions: According to the inclusion and exclusion criteria, 96 clinical records (HC) from 2013 were obtained. A validated collection instrument was used. Descriptive analysis was performed with STATA version 25 statistical software. Results: Of the 96 CHs, the average age was 55.04 years, the most frequent microbial agents were: Escherichia Coli with 85.3%, Staphylococcus saprophyticus 4.2% and Klebsiella pneumoniae 3.1%. The prevalence of extended spectrum beta-lactamase producers (ESBL) was 10.4%. The most resistant antibiotics were trimethoprim / sulfamethoxazole 89.6 %, ampicillin 86 %, piperacillin 84.6 %, tetracycline 79.2 % and ciprofloxacin 70.8 %. The most sensitive antibiotics were: amikacin 100%, imipenem 100%, ertapenem 98%, meropenem 96% and piperacillin / tazobactam 96%. Conclusion: The most common uropathogen in hospitalized UTI patients was E. coli. The antibiotics that showed resistance to E. coli were: trimethoprim/sulfamethoxazole, ampicillin, piperacillin, tetracycline, and ciprofloxacin, and for S. saprophyticus they were: amoxicillin/clavulanic acid, trimethoprim / sulfamethoxazole, ceftriaxone and ciprofloxacin(AU)


Subject(s)
Humans , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Urinary Tract Infections/drug therapy , Drug Resistance, Bacterial , Escherichia coli/drug effects , Staphylococcus saprophyticus/drug effects , Peru/epidemiology , Drug Resistance, Microbial/immunology , Medical Records , Cross-Sectional Studies , Hospitals, Public , Klebsiella pneumoniae/drug effects , Anti-Infective Agents, Urinary/therapeutic use
8.
Rev. Méd. Clín. Condes ; 32(4): 442-448, jul - ago. 2021. tab
Article in Spanish | LILACS | ID: biblio-1518781

ABSTRACT

Las infecciones del tracto urinario (ITU) son una consulta ambulatoria frecuente, afectan mayormente a mujeres y han ido en aumento en todas las edades, especialmente en adultos mayores. A su vez, la resistencia antimicrobiana está aumento progresivamente en el tiempo y esquemas antibióticos tradicionales han perdido su utilidad clínica. En particular, el aumento de resistencia de E. coli, como principal uropatógeno, es una realidad presente en diversos países y un mayor desafío lo constituyen las ITU causadas por cepas de E. coli productoras de betalactamasas de espectro expandido. El presente artículo revisa los factores de riesgo asociados al aislamiento de cepas resistentes, los cuadros clínicos más frecuentes, y también el diagnóstico y manejo en la situación actual a nivel ambulatorio.


Urinary tract infections (UTI) are a frequent outpatient consultation, it affects mostly women, and is becoming more common in all ages, especially in the elderly. Concurrently, antimicrobial resistance is progressively increasing over time and traditional antibiotic regimens have lost their clinical efficacy. In particular, in many countries the increase in resistance of E. coli (the main uropathogen) is a reality, making UTIs caused by E. coli strains that produce expanded spectrum beta-lactamases the greater challenge. This article reviews the risk factors associated with the isolation of resistant strains, common clinical presentations, and also current diagnosis and management of outpatients.


Subject(s)
Humans , Urinary Tract Infections/diagnosis , Urinary Tract Infections/drug therapy , Ambulatory Care , Urinary Tract Infections/microbiology , Microbial Sensitivity Tests , Risk Factors , Escherichia coli/isolation & purification , Anti-Bacterial Agents/therapeutic use
9.
China Journal of Chinese Materia Medica ; (24): 3388-3393, 2021.
Article in Chinese | WPRIM | ID: wpr-887989

ABSTRACT

To study the mechanism of polysaccharides from seeds of Vaccaria segetalis( PSV) in the treatment of bacterial cystitis through the NLRP3 inflammasome pathway. The rat model of urinary tract infection was used and treated with PSV,and the urine and bladders were collected. The level of interleukin-10( IL-10) in rat urine was detected by enzyme linked immunosorbent assay( ELISA). Western blot and immunofluorescence staining were used to detect the expressions of sonic hedgehog( SHH) and NLRP3 inflammasome [NOD-like receptor thermoprotein domain 3( NLRP3),apoptosis associated speck like protein( ASC) and pro-caspase-1]. The expression of Toll-like receptor pathway was detected by RT-PCR. The death of 5637 cells induced by uropathogenic Escherichia coli( UPEC) and lactate dehydrogenase( LDH) release were evaluated using live/dead staining. The results showed that in the rat bladder,the expressions of SHH,NLRP3 inflammasomes and Toll-like receptors were significantly up-regulated,and NLRP3 inflammasomes were significantly activated by UPEC infection. The administration with PSV could significantly increase the concentration of IL-10 in urine,inhibit the expressions of SHH,NLRP3 inflammasomes and Toll-like receptors in bladder,and inhibit the activation of NLRP3 inflammasomes. A large number of 5637 cells were dead after UPEC infection and caused LDH production. PSV could significantly inhibit the death of 5637 cells and the release of LDH. In conclusion,PSV could inhibit the expression and activation of NLRP3 inflammasomes by inhibiting the Toll-like receptor pathway,thereby mitigating the bladder injury.


Subject(s)
Animals , Rats , Hedgehog Proteins , Inflammasomes/genetics , Interleukin-1beta , NLR Family, Pyrin Domain-Containing 3 Protein/genetics , Polysaccharides/pharmacology , Seeds , Urinary Bladder , Urinary Tract Infections/drug therapy , Vaccaria
10.
Femina ; 49(6): 373-378, 2021. graf
Article in Portuguese | LILACS | ID: biblio-1290582

ABSTRACT

Objetivo: O presente estudo tem como objetivo avaliar o perfil de sensibilidade antimicrobiana do patógeno mais comum causador da infecção do trato urinário (ITU) de gestantes que foram internadas em um hospital de ensino do município de São Paulo em determinado período. Métodos: Estudo retrospectivo, transversal, quantitativo, realizado avaliando as uroculturas positivas e o perfil de sensibilidade antimicrobiana dos agentes mais comuns encontrados em ITUs das gestantes de hospital e maternidade-escola do município de São Paulo de janeiro de 2019 até janeiro de 2020. Resultados: A partir da análise de uroculturas positivas e antibiograma de 149 gestantes admitidas com quadro de infecção urinária no referido hospital no intervalo de tempo analisado, constatou-se que 83,89% dos casos apresentaram como patógeno a bactéria Escherichia coli. No âmbito da resistência bacteriana, percebeu-se que o maior índice foi encontrado no que tange a cefalotina (65%), ampicilina (58%) e ampicilina/sulbactam (45%). Ademais, a partir das análises individuais, 20 pacientes, ou seja, aproximadamente 13,42% apresentaram cepas sensíveis a todas as medicações apontadas, e as demais apresentaram resistência a, pelo menos, uma delas. Conclusão: A partir da premissa de eficácia desempenhada pelo protocolo de medicação empírica estabelecido pela instituição no tocante ao tratamento de infecção do trato urinário em gestantes, a cefalotina certamente não deveria compor o rol de drogas ofertadas às pacientes. Isso se dá, pois a sensibilidade apresentada pela Escherichia coli, patógeno que mais comumente está associado aos quadros de ITU do serviço, a essa droga é muito baixa. Já a nitrofurantoína apresentou um satisfatório espectro de cobertura, sendo a resistência à droga inferior a 10%. Com isso, conclui-se que ela deve permanecer como droga inicial para as ITUs das gestantes que chegam a essa instituição.(AU)


Objective: The present study aims to evaluate the antimicrobial sensitivity profile of the most common pathogen that causes urinary tract infection (ITU) in pregnant women who were admitted to a Teaching Hospital in the city of São Paulo in a specific period. Methods: Retrospective, cross-sectional, quantitative study carried out evaluating positive urine cultures and the antimicrobial sensitivity profile of the most common agents found in ITU of pregnant women at Teaching Maternity hospital in the city of São Paulo from January 2019 to January 2020. Results: From the of positive urine culture and antibiogram of 149 pregnant women admitted with a urinary tract infection in the referred hospital in the analyzed period of time, it was found that 83.89% of the cases presented the bacterium Escherichia coli as a pathogen. In the scope of bacterial resistance, it was noticed that the highest index was found with respect to Cephalothin (65%), ampicillin (58%) and ampicillin/sulbactam (45%). Furthermore, from the individual analyzes, 20 patients, that is, approximately 13.42% had strains sensitive to all the medications indicated, with the others showing resistance to at least one of them. Conclusion: Based on the premise of efficacy performed by the empirical medication protocol established by the institution regarding the treatment of urinary tract infection in pregnant women, Cephalothin should certainly not be included in the list of drugs offered to patients. This happens because the sensitivity presented by Escherichia coli, the most commonly pathogen associated with the UTI pathogen of the service, to this drug is very low. Nitrofurantoin, on the other hand, presented a satisfactory coverage spectrum, with drug resistance below 10%. Thus, it is concluded that this should remain as an initial drug for ITUs of pregnant women who arrive at this institution.(AU)


Subject(s)
Humans , Female , Pregnancy , Urinary Tract Infections/diagnosis , Urinary Tract Infections/microbiology , Urinary Tract Infections/drug therapy , Drug Resistance, Microbial/drug effects , Pregnancy Complications/microbiology , Brazil/epidemiology , Cross-Sectional Studies
11.
Rev. chil. infectol ; 37(6): 683-689, dic. 2020. ilus, tab
Article in Spanish | LILACS | ID: biblio-1388189

ABSTRACT

INTRODUCCIÓN: Para el caso de infección urinaria adquirida en la comunidad la identificación de enterobacterias con beta-lactamasas de espectro extendido (BLEE) puede optimizar las estrategias de tratamiento, control y seguimiento; sin embargo, el efecto de prevalencias variables de este patrón de resistencia ha afectado la validez externa de este tipo de modelos. OBJETIVO: Desarrollar un modelo predictor diagnóstico que ajuste el error de predicción en prevalencias variables utilizando la regresión LASSO. MÉTODOS: Se diseñó un modelo predictor diagnóstico de infección urinaria adquirida en la comunidad por enterobacterias productoras de BLEE. Se empleó un estudio de corte transversal, tanto para la construcción como para la validación. Para evaluar el efecto de la prevalencia variable del desenlace, la validación se realizó con población en la que la proporción de aislados con este mecanismo de resistencia fue menor, los participantes fueron pacientes adultos que consultaron a servicios de urgencias de dos instituciones hospitalarias de mediano nivel de complejidad de la ciudad de Medellín. Para ajustar el efecto de un medio ambiente con menor proporción de resistencia antimicrobiana, utilizamos la contracción de predictores por regresión LASSO. RESULTADOS: Se incluyeron 303 pacientes para la construcción del modelo, se evaluaron seis predictores y la validación se realizó en 220 pacientes. CONCLUSIÓN: El modelo ajustado con regresión LASSO favoreció la validez externa del modelo en poblaciones con proporción de aislados productores de BLEE en urocultivo de pacientes ambulatorio entre 11 y 16%. Este estudio brinda criterios para un aislamiento temprano cuando los predictores están presentes en poblaciones con proporciones de resistencia en urocultivos ambulatorios cercanas a 15% y propone una metodología para ajuste de error en el diseño de modelos de predicción en resistencia antimicrobiana


BACKGROUND: In the case of community-acquired urinary tract infection, the identification of Enterobacteriaceae with extended spectrum beta-lactamases (ESBL) can optimize treatment, control and follow-up strategies, however the effect of variable prevalences of this resistance pattern has affected the external validity of this type of models. AIM: To develop a diagnostic predictive model that adjusts the prediction error in variable prevalences using the LASSO regression. METHODS: A diagnostic predictive model of community-acquired urinary tract infection by infection by ESBL producing Enterobacteriaceae was designed. A cross-sectional study was used for both construction and validation. To assess the effect of the variable prevalence of the outcome, the validation was performed with a population in which the proportion of isolates with this resistance mechanism was lower, the participants were adult patients who consulted the emergency services of two medium-level hospital institutions. complexity of the city of Medellin. To adjust for the effect of an environment with a lower proportion of antimicrobial resistance, we used the contraction of predictors by LASSO regression. RESULTS: 303 patients were included for the construction of the model, six predictors were evaluated and validation was carried out in 220 patients. CONCLUSION: The adjusted model with LASSO regression favored the external validity of the model in populations with a proportion of ESBL producing isolates in urine culture of outpatients between 11 and 16%. This study provides criteria for early isolation when predictors are present in populations with proportions of resistance in ambulatory urine cultures close to 15% and proposes a methodology for the adjustment of errors in the design of prediction models for antimicrobial resistance.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Urinary Tract Infections/drug therapy , Urinary Tract Infections/epidemiology , Community-Acquired Infections/drug therapy , Enterobacteriaceae Infections/drug therapy , Enterobacteriaceae Infections/epidemiology , beta-Lactamases , Microbial Sensitivity Tests , Logistic Models , Prevalence , Cross-Sectional Studies , Drug Resistance, Bacterial , Anti-Bacterial Agents/therapeutic use , Anti-Bacterial Agents/pharmacology
12.
Rev. chil. infectol ; 37(5): 523-530, nov. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1144246

ABSTRACT

Resumen Introducción: Las infecciones del tracto urinario (ITU) presentan una elevada prevalencia en el ámbito comunitario. Un rápido diagnóstico microbiológico es esencial para asegurar una terapia adecuada y efectiva. Objetivo: Evaluar un kit de antibiograma rápido (KAR®) en formato point-of-care para la detección rápida de ITU y sensibilidad antimicrobiana. Material y Métodos: El dispositivo KAR® se diseñó y desarrolló en colaboración con ingenieros técnicos y microbiólogos clínicos. Su evaluación se realizó a través de un estudio multicéntrico en el que participaron tres hospitales españoles. Para ello, se realizaron distintos ensayos in vivo con el fin de determinar la correlación del dispositivo con las técnicas microbiológicas de referencia. Resultados: Se ensayó un total de 400 muestras de orinas procedentes de pacientes con sospecha de ITU. El dispositivo KAR® proporcionó rápidos resultados (tiempo medio de positividad de 7,8 ± 1,5 h) con 97% de sensibilidad, 89% de especificidad y 87% de concordancia para la detección de bacteriuria significativa. Los porcentajes de especificidad para los antimicrobianos testados fueron: ciprofloxacina (97%), fosfomicina (94%), cotrimoxazol (84%), ampicilina (80%) y amoxicilina/ácido clavulánico (55%). Conclusión: El dispositivo KAR® puede ser una herramienta útil para el diagnóstico de ITU en pacientes ambulatorios, especialmente en áreas de bajo nivel socio-económico.


Abstract Background: Urinary tract infections (UTI) presents a high prevalence in the community setting. Rapid and accurate microbiological diagnosis is essential to ensure adequate and effective therapy. Aim: To evaluate a rapid antibiogram kit (KAR®) in point-of-care format for rapid detection of UTI and antibiotic susceptibility. Methods: The KAR® device has been designed and developed in collaboration with technical engineers and clinical microbiologists. Its evaluation has been carried out through a multicenter study in which three Spanish hospitals have participated. Thus, different in vivo tests have been implemented in order to determine device correlation with the reference microbiological techniques. Results: During the study period, a total of 400 urine samples from patients with suspected ITU were tested. The KAR® device provided fast results (mean positivity time of 7,8 ± 1,5 hours) with 97% sensitivity, 89% specificity and 87% agreement for the detection of significant bacteriuria. The percentages of specificity for the antibiotics tested were: ciprofloxacin (97%), fosfomycin (94%),cotrimoxazole (84%), ampicillin (80%) and amoxicillin/clavulanic acid (55%). Conclusion: The KAR® device could be a useful tool for diagnosing UTI in outpatients, especially in areas of low socio-economic level.


Subject(s)
Humans , Urinary Tract Infections/diagnosis , Urinary Tract Infections/drug therapy , Point-of-Care Systems , Microbial Sensitivity Tests , Prevalence , Anti-Bacterial Agents/therapeutic use
13.
Medicina (B.Aires) ; 80(3): 229-240, jun. 2020. tab
Article in Spanish | LILACS | ID: biblio-1125074

ABSTRACT

La Sociedad Argentina de Infectología y otras sociedades científicas han actualizado estas recomendaciones utilizando, además de información internacional, la de un estudio multicéntrico prospectivo sobre infecciones del tracto urinario del adulto realizado en Argentina durante 2016-2017. La bacteriuria asintomática debe ser tratada solo en embarazadas, a quienes también se las debe investigar sistemáticamente; los antibióticos de elección son nitrofurantoína, amoxicilina, amoxicilina-clavulánico, cefalexina y trimetoprima-sulfametoxazol. Ante procedimientos que impliquen lesión con sangrado del tracto urinario se recomienda solicitar urocultivo para pesquisar bacteriuria asintomática, y, si resultara positivo, administrar antimicrobianos según sensibilidad desde inmediatamente antes hasta 24 horas luego de la intervención. En mujeres, la cistitis puede ser tratada con nitrofurantoina, cefalexina, o fosfomicina y no se recomienda usar trimetoprima-sulfametoxazol o fluoroquinolonas; en pielonefritis puede emplearse ciprofloxacina, cefixima o cefalexina si el tratamiento es ambulatorio o ceftriaxona, cefazolina o amikacina si es hospitalario. En los hombres, las infecciones del tracto urinario se consideran siempre complicadas. Se recomienda tratamiento con nitrofurantoina o cefalexina por 7 días, o bien monodosis con fosfomicina. Para la pielonefritis en hombres se sugiere ciprofloxacina, ceftriaxona o cefixima si el tratamiento es ambulatorio y ceftriaxona o amikacina si es hospitalario. Se sugiere tratar las prostatitis bacterianas agudas con ceftriaxona o gentamicina. En cuanto a las prostatitis bacterianas crónicas, si bien su tratamiento de elección hasta hace poco fueron las fluoroquinolonas, la creciente resistencia y ciertas dudas sobre la seguridad de estas drogas obligan a considerar el uso de alternativas como fosfomicina.


The Argentine Society of Infectious Diseases and other scientific societies have updated these recommendations based on data on urinary tract infections in adults obtained from a prospective multicenter study conducted in Argentina during 2016-2017. Asymptomatic bacteriuria should be treated only in pregnant women, who should also be systematically investigated; the antibiotics of choice are nitrofurantoin, amoxicillin, clavulanic/amoxicillin, cephalexin and trimethoprim-sulfamethoxazole. In procedures involving injury to the urinary tract with bleeding, it is recommended to request urine culture and, in the presence of bacteriuria, antimicrobial treatment according to sensitivity should be prescribed from immediately before up to 24 hours after the intervention. In women, cystitis can be treated with nitrofurantoin, cephalexin or fosfomycin, while trimethoprim-sulfamethoxazole and fluoroquinolones are not recommended; pyelonephritis can be treated with ciprofloxacin, cefixime or cephalexin in ambulatory women or ceftriaxone, cefazolin or amikacin in those who are hospitalized. In men, urinary tract infections are always considered complicated; nitrofurantoin or cephalexin are recommended for 7 days, alternatively fosfomycin should be given in a single dose. In men, ciprofloxacin, ceftriaxone or cefixime are suggested for pyelonephritis on ambulatory treatment whereas ceftriaxone or amikacin are recommended for hospitalized patients. Acute bacterial prostatitis can be treated with ceftriaxone or gentamicin. Fluoroquinolones were the choice treatment for chronic bacterial prostatitis until recently; they are no longer recommended due to the increasing resistance and recent concerns regarding the safety of these drugs; alternative antibiotics such as fosfomycin are to be considered.


Subject(s)
Humans , Male , Female , Pregnancy , Argentina , Urinary Tract Infections/drug therapy , Consensus , Anti-Infective Agents, Urinary/therapeutic use , Prostatitis/diagnosis , Prostatitis/drug therapy , Pyelonephritis/diagnosis , Pyelonephritis/drug therapy , Urinary Tract Infections/diagnosis , Prospective Studies , Cystitis/diagnosis , Cystitis/drug therapy
14.
Medicina (B.Aires) ; 80(3): 241-247, jun. 2020.
Article in Spanish | LILACS | ID: biblio-1125075

ABSTRACT

La segunda parte del Consenso Argentino Intersociedades de Infección Urinaria incluye el análisis de situaciones especiales. En pacientes con sonda vesical se debe solicitar urocultivo solo cuando hay signo-sintomatología de infección del tracto urinario, antes de instrumentaciones de la vía urinaria o como control en pacientes post-trasplante renal. El tratamiento empírico recomendado en pacientes sin factores de riesgo es cefalosporinas de tercera generación o aminoglucósidos. Las infecciones del tracto urinario asociadas a cálculos son siempre consideradas complicadas. En caso de obstrucción con urosepsis, deberá realizarse drenaje de urgencia por vía percutánea o ureteral. En pacientes con stents o prótesis ureterales, como catéteres doble J, el tratamiento empírico deberá basarse en la epidemiología, los antibióticos previos y el estado clínico. Antes del procedimiento de litotricia extracorpórea se recomienda pesquisar la bacteriuria y, si es positiva, administrar profilaxis antibiótica según el antibiograma. Cefalosporinas de primera generación o aminoglúcosidos son opciones válidas. Se recomienda aplicar profilaxis antibiótica con cefalosporinas de primera generación o aminoglúcosidos antes de la nefrolitotomía percutánea. La biopsia prostática trans-rectal puede asociarse a complicaciones infecciosas, como infecciones del tracto urinario o prostatitis aguda, principalmente por Escherichia coli u otras enterobacterias. En pacientes sin factores de riesgo para gérmenes multirresistentes y urocultivo negativo se recomienda realizar profilaxis con amikacina o ceftriaxona endovenosas. En pacientes con urocultivo positivo, se realizará profilaxis según antibiograma, 24 horas previas a 24 horas post-procedimiento. Para el tratamiento dirigido de la prostatitis post-biopsia trans-rectal, los carbapenémicos durante 3-4 semanas son el tratamiento de elección.


The second part of the Inter-Society Argentine Consensus on Urinary Tract Infection (UTI) includes the analysis of special situations. In patients with urinary catheter, urine culture should be requested only in the presence of UTI symptomatology, before instrumentation of the urinary tract, or as a post-transplant control. The antibiotics recommended for empirical treatment in patients without risk factors are third-generation cephalosporins or aminoglycosides. UTIs associated with stones are always considered complicated. In case of obstruction with urosepsis, an emergency drainage should be performed via a percutaneous nefrostomy or ureteral stenting. In patients with stents or ureteral prostheses, such as double J catheters, empirical treatment should be based on epidemiology, prior antibiotics, and clinical status. Before the extracorporeal lithotripsy procedure, bacteriuria should be investigated and antibiotic prophylaxis should be administered in case of positive result, according to the antibiogram. First generation cephalosporins or aminoglycosides are valid alternatives. The use of antibiotic prophylaxis with first-generation cephalosporins or aminoglycosides before percutaneous nephrolithotomy is recommended. Transrectal prostatic biopsy can be associated with infectious complications, such as UTI or acute prostatitis, mainly due to Escherichia coli or other enterobacteria. In patients without risk factors for multiresistant bacteria and negative urine culture, prophylaxis with intravenous amikacin or ceftriaxone is recommended. In patients with positive urine culture, prophylaxis will be performed according to the antibiogram, from 24 hours before to 24 hours post-procedure. For the targeted treatment of post-transrectal biopsy prostatitis, carbapenems for 3-4 weeks are the treatment of choice.


Subject(s)
Humans , Male , Female , Urinary Tract Infections/etiology , Urinary Tract Infections/drug therapy , Consensus , Anti-Infective Agents, Urinary/therapeutic use , Argentina , Prostatitis/etiology , Prostatitis/drug therapy , Lithotripsy/adverse effects , Stents/adverse effects , Risk Factors , Nephrolithiasis/complications , Urinary Catheters/adverse effects , Nephrolithotomy, Percutaneous/adverse effects
15.
J. bras. nefrol ; 42(1): 124-126, Jan.-Mar. 2020. graf
Article in English, Portuguese | LILACS | ID: biblio-1098346

ABSTRACT

Abstract Urinary tract infection is a serious public health issue that predominantly affects women. In men, it is more often associated with prostatic hyperplasia and bladder catheterization. Urogenital tuberculosis presents with nonspecific with nonspecific symptoms and the diagnosis can be made in the presence of sterile leukocyturia and recurrent infection with acid urine. Non-tuberculous mycobacteria or other non-tuberculosis mycobacteria are opportunistic pathogens that inhabit the soil, water or environment surfaces, and usually cause diseases in immunocompromised individuals. Mycobacterium abscessus is an agent that causes lung, skin and soft tissue hospital infections. Urinary tract infections by this pathogen are rare.


Resumo Infecção do trato urinário é um sério problema de saúde pública que acomete predominantemente as mulheres. Em homens, está mais relacionada com hiperplasia prostática e cateterismo vesical. A tuberculose urogenital cursa com sintomas inespecíficos e o diagnóstico pode ser aventado na presença de leucocitúria estéril, e infecção recorrente com urina ácida. Micobactérias não tuberculosas ou mycobacteria other than tuberculosis são patógenos oportunistas que habitam o solo, a água ou superfícies do meio ambiente, e geralmente causam doenças em imunodeprimidos. Mycobacterium abscessus é um agente que causa infecções nosocomiais, pulmonares, de pele e de tecidos moles. Infecção urinária decorrente desse patógeno é considerada rara.


Subject(s)
Humans , Male , Middle Aged , Urinary Tract Infections/diagnosis , Mycobacterium abscessus/isolation & purification , Mycobacterium Infections, Nontuberculous/diagnosis , Urinary Tract Infections/microbiology , Urinary Tract Infections/drug therapy , Amikacin/administration & dosage , Follow-Up Studies , Treatment Outcome , Clarithromycin/administration & dosage , Anti-Bacterial Agents/administration & dosage , Mycobacterium Infections, Nontuberculous/microbiology , Mycobacterium Infections, Nontuberculous/drug therapy
16.
Ribeirão Preto; s.n; 2020. 85 p. ilus.
Thesis in Portuguese | LILACS, BDENF | ID: biblio-1382295

ABSTRACT

Introdução: O câncer de mama representa a neoplasia mais incidente em mulheres, com projeção para representar 29% de todos os tipos de câncer para o biênio 2018-2019 no Brasil. A quimioterapia é a modalidade terapêutica mais utilizada para o tratamento desta neoplasia, utilizando-se largamente a droga ciclofosfamida, a qual apresenta diversos eventos adversos, dentre eles a supressão gônodal que pode induzir ou intensificar os sintomas menopausais. Objetivo: Analisar a qualidade de vida e ocorrência de sintomas geniturinários durante o tratamento quimioterápico adjuvante com os esquemas FAC; AC-T, CMF ou TC para câncer de mama. Método: Estudo prospectivo que avaliou mulheres antes (T0) e 30 dias após a realização do tratamento quimioterápico(T1). Foram avaliadas quanto ao status menopausal, a força e resistência exercida pelos músculos do assoalho pélvico com o perineômetro, além, de responderem a um questionário sociodemográfico, escala de avaliação da menopausa e o ICIQ-SF. Os dados foram analisados por meio de testes com qui-qradrado, teste t, análise multifatorial para medias repetidas, LSD-Fisher e análise de componentes principais. Resultados: A média de idade foi de 46,3 anos (DP± 5,77), as caraterísticas de maior prevalecia foram a hipertensão arterial (35%), carcinoma ducal infiltrante (90,2%), e estadiamento clinico em IIA (40%). Anterior a quimioterapia 60% das mulheres apresentavam ciclos menstruais regulares, mas nenhuma manteve a regularidade após quimioterapia tornaram-se amenorreicas. A escala de avaliação da menopausa apresentou piora significativa dos sintomas menopausais quando comparados T0 e T1(p<0,05) e quanto ao ICIQ-SF todas as mulheres apresentaram aumento significativo das médias do score final (p<0,001), demonstrando piora dos sintomas urinários e qualidade de vida. Os valores de contração rápida e lenta verificados com o perineômetro em T0 apresentaram redução significativa em T1 (p<0,05) e observou-se aumento da incidência de incontinência urinária de esforço. A análise dos componentes principais sintetizou os resultados mostrando que as variáveis obtidas pela perineometria, Escala de avaliação de menopausa ICIQ-SF não diferiam entre grupos de quimioterapia, status menopausal e número de partos (p>0,05), porém ao longo das avaliações, entre T0 e T1, houve diferença estatística (p<005). Conclusão: A exposição ao tratamento quimioterápico contendo ciclofosfamida, independente de outros fatores aqui avaliados, promove alterações geniturinárias


Introduction: Breast cancer represents the most common cancer in women, projected to represent 29% of all cancers for the 2018-2019 biennium in Brazil. Chemotherapy is the most widely used therapeutic modality for the treatment of this neoplasm, largely using the drug cyclophosphamide, which has several adverse events, including gonodal suppression that can induce or intensify menopausal symptoms. Objective: To analyze the quality of life and occurrence of genitourinary symptoms during adjuvant chemotherapy treatment with FAC regimens AC-T, CMF or CT for breast cancer. Method: Prospective study that evaluated women before (T0) and 30 days after chemotherapy (T1). They were evaluated for menopausal status, strength and endurance exerted by the pelvic floor muscles with the perineometer, and answered a sociodemographic questionnaire, menopause assessment scale and the ICIQ-SF. Data were analyzed using chi-square tests, t-test, repeated-factor multifactorial analysis, LSD-Fisher and principal component analysis. Results: The mean age was 46.3 years (SD ± 5.77), the most prevalent characteristics were arterial hypertension (35%), infiltrating ducal carcinoma (90.2%), and clinical staging in IIA (40%). Prior to chemotherapy 60% of women had regular menstrual cycles, but none maintained regularity after chemotherapy became amenorrheic. The menopause assessment scale showed a significant worsening of the menopausal symptoms when compared to T0 and T1 (p<0.05). Regarding the ICIQ-SF, all women presented a significant increase in the final score means (p<0.001), showing a worsening of the urinary symptoms and quality of life. The fast and slow contraction values verified with the perineometer at T0 showed a significant reduction at T1 (p<0.05) and an increased incidence of stress urinary incontinence was observed. The principal component analysis summarized the results showing that the variables obtained by perineometry, ICIQ-SF Menopause Rating Scale did not differ between chemotherapy groups, menopausal status and number of deliveries (p>0.05), but throughout the evaluations, between T0 and T1, there was a statistical difference (p<005). Conclusion: Exposure to chemotherapeutic treatment containing cyclophosphamide, regardless of other factors evaluated here, promotes genitourinary changes


Subject(s)
Humans , Female , Quality of Life , Urinary Tract Infections/drug therapy , Breast Neoplasms/drug therapy , Carcinoma/drug therapy , Drug-Related Side Effects and Adverse Reactions , Antineoplastic Agents/adverse effects
18.
Rev. epidemiol. controle infecç ; 9(4): 292-298, out.-dez. 2019. ilus
Article in Portuguese | LILACS | ID: biblio-1152255

ABSTRACT

Justificativa e Objetivos: Muitos avanços ocorreram em prevenção, diagnóstico e tratamento das doenças infecciosas, porém elas ainda são as principais causas de hospitalização e morte em idosos. O objetivo deste trabalho foi verificar o benefício do uso de antimicrobianos e sua associação com a implementação de outras medidas terapêuticas e com a indicação de cuidados paliativos nas duas últimas semanas de vida de idosos em internação hospitalar, a fim de subsidiar o desenvolvimento de modelos racionais de prescrição para este grupo. Métodos: Foi desenvolvido um estudo retrospectivo realizado pela análise de prontuários dos idosos participantes do estudo epidemiológico do tipo coorte "Desenvolvimento de uma linha de cuidados para o idoso no Hospital Universitário de Santa Maria" que apresentaram óbito como desfecho. Resultados: Dos 97 indivíduos avaliados, 89,7% (n = 87) fizeram uso de antibiótico nas duas últimas semanas de vida. Entre aqueles que utilizaram antibacteriano, 38,9% apresentaram sinais clínicos de melhora após o início do tratamento (n = 28). Assim, foi possível afirmar que não houve associação entre o alívio dos sintomas e o uso de antibacteriano (p = 0,377). Entre aqueles que se beneficiaram da antibioticoterapia, 46,4% foram indicados para infecção respiratória e 14,3% para infecção do trato urinário. Não foi encontrada dependência entre o uso de antibacteriano e as outras medidas terapêuticas adotadas (p = 0,057), nem com a indicação de cuidado paliativo (p = 0,065). Conclusão: Observou-se pouca evidência de benefício no uso de antibacteriano no grupo estudado, o que sinaliza a necessidade de uma adequação de plano de cuidado diferenciada para esse perfil de pacientes.(AU)


Background and objectives: Many advances have occurred in the prevention, diagnosis and treatment of infectious diseases, but they are still the main causes of hospitalization and death in older adults. The objective of this study was to verify the benefit of antimicrobial use and its association with the implementation of other therapeutic measures and with the indication of palliative care in the last two weeks of life of hospitalized older adults, in order to subsidize the development of rational models for this group. Methods: A retrospective study was carried out by analyzing the medical records of the older adult participants of the cohort epidemiological study "Development of a Care Line for Older Adults at the University Hospital of Santa Maria", which presented death as an outcome. Results: Of the 97 individuals evaluated, 89.7% (n = 87) used antibiotics in the last two weeks of life. Among those who used antibacterial agents, 38.9% presented clinical signs of improvement after treatment initiation (n=28). Thus, it was possible to affirm that there was no association between symptom relief and antibacterial use (p = 0.377). Among those who benefited from antibiotic therapy, 46.4% were indicated for respiratory infection and 14.3% for urinary tract infection. We found no dependence between the use of antibacterial drugs and the other therapeutic measures adopted (p = 0.057), nor with the indication of palliative care (p = 0.065). Conclusion: There was little evidence of benefit in the use of antibiotics in the studied group, which indicates the need for a different care plan adequacy for this patient profile.(AU)


Justificación y Objetivos: Ocurrieron muchos avances en la prevención, diagnóstico y tratamiento de las enfermedades infecciosas, pero todavía son las principales causas de hospitalización y muerte en ancianos. El presente trabajo tuvo como objetivo verificar el beneficio del uso de antimicrobianos y su asociación con la implementación de otras medidas terapéuticas y con la indicación de cuidados paliativos en las dos últimas semanas de vida de ancianos en internación hospitalaria con el fin de fomentar el desarrollo de modelos racionales de prescripción para este grupo. Métodos: Se desarrolló un estudio retrospectivo realizado por el análisis de historiales de los ancianos participantes del estudio epidemiológico del tipo cohorte "Desarrollo de una línea de cuidados para el anciano en el Hospital Universitario de Santa María", que presentaron muerte como desenlace. Resultados: De los 97 individuos evaluados, el 89,7% (n = 87) hicieron uso de antibiótico en las dos últimas semanas de vida. Entre los que utilizaron el antibacteriano, el 38,9% presentó signos clínicos de mejora después del inicio del tratamiento (n = 28). Así fue posible afirmar que no hubo asociación entre el alivio de los síntomas y el uso de antibacteriano (p = 0,377). Entre los que se beneficiaron de la antibioticoterapia, el 46,4% fue indicado para infección respiratoria y el 14,3% para infección del tracto urinario. No se encontró dependencia entre el uso de antibacteriano y las otras medidas terapéuticas adoptadas (p = 0,057), ni con la indicación de cuidado paliativo (p = 0,065). Conclusión: Se observó poca evidencia de beneficio en el uso de antibacteriano en el grupo estudiado, lo que señala la necesidad de una adecuación del plan de cuidado diferenciada para ese perfil de pacientes.(AU)


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Palliative Care , Drug Prescriptions , Terminal Care , Hospitalization , Anti-Bacterial Agents/therapeutic use , Respiratory Tract Infections/drug therapy , Bacterial Infections/microbiology , Bacterial Infections/drug therapy , Urinary Tract Infections/drug therapy , Retrospective Studies , Therapeutic Index
19.
Rev. Inst. Nac. Hig ; 50(1-2): 4-13, Diciembre 2019. Tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1118292

ABSTRACT

Las infecciones del tracto urinario afectan al ser humano a lo largo de su vida y son frecuentes tanto en el ámbito comunitario como en el nosocomial. El objetivo de este estudio fue Identificar los principales agentes etiológicos y el perfil de resistencia a los antibióticos, presentado por los microorganismos más frecuentemente aislados de los urocultivos de pacientes con infección urinaria que acudieron al Laboratorio "Luis Razetti" Mérida -Venezuela, entre enero y junio de 2015. Este estudio fue de tipo observacional, de corte transversal y descriptivo. La población y muestra estuvo conformada por 149 pacientes de ambos sexos, cuyas muestras de orina fueron procesadas utilizado el método del asa calibrada y la identificación bacteriana mediante pruebas bioquímicas convencionales. La susceptibilidad antimicrobiana se determinó a través del método de difusión del disco en agar. Escherichia coli predominó en un 84,6 %, seguido de Proteus mirabilis y Enterococcus faecalis, ambos con (4,7 %). Los porcentajes más altos de resistencia para los aislados de E. coli, se observaron para ampicilina (92,06 %), ampicilina/sulbactam (68,25 %), ácido nalidíxico (38,89 %), ciprofloxacina (38,89 %) y trimetroprim­sulfametoxazol (54,76 %); y presentaron altos niveles de sensibilidad a Nitrofurantoína (80,95 %). El 5,15 % de las cepas de E. coli se mostraron fenotípicamente productoras de belalactamasa de espectro extendido y el 35,29 % de las otras Enterobacteriaceae aisladas, presentaron un perfil fenotípico compatible con la producción de la enzima Inhibitory-resistant TEM (IRT). Es importante destacar que estos estudios permiten conocer la etiología a de infecciones urinarias en la comunidad, así como los perfiles de resistencia y sensibilidad a nivel local, datos relevantes para establecer pautas de tratamiento empírico adaptadas a cada medio.


Urinary tract infections affect the human being throughout his life and are among the most frequent in both the community and nosocomial settings. The Aim of this study was to Identify the main etiological agents and antibiotic resistance profile presented by isolated microorganisms in the urocultures of patients with urinary tract infection who attended the Laboratory "Luis Razetti" Mérida -Venezuela, between January and June 2015. This study was observational, cross-sectional and descriptive. The population and sample consisted of 149 patients of both sexes, whose urine samples were processed using the calibrated handle method and bacterial identification through conventional biochemical tests. The antimicrobial susceptibility is determined through the disk diffusion method in agar. Escherichia coli dominated by 84.6 %, followed by Proteus mirabilis and Enterococcus faecalis, both with (4.7 %). The highest percentages of resistance for E. coli were observed for ampicillin (92.06 %), ampicillin/sulbactam (68.25 %), nalidixic acid (38.89 %), ciprofloxacin (38.89 %) trimetroprim-sulfamethoxazole (54.76 %); and had high levels of sensitivity to Nitrofurantoin (80.95 %). 5.15 % of E. coli strains were phenotypically producing extended-spectrum belalactamase and 35.29 % of others Enterobacteriaceae isolated had a phenotypic profile compatible with the production of the Enzyme Inhibitoryresistant TEM (IRT). It is important to note that these studies allow knowing the etiology of urinary tract infections in the community as well as resistance and sensitivity profiles at the local level, relevant data to establish empirical processing guidelines tailored to each medium.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Urinary Tract Infections/microbiology , Urinary Tract Infections/drug therapy , Drug Resistance, Bacterial , Escherichia coli/isolation & purification , Anti-Bacterial Agents/therapeutic use , Phenotype , Cross-Sectional Studies , Community-Acquired Infections/microbiology , Community-Acquired Infections/drug therapy , Escherichia coli/drug effects , Escherichia coli/genetics , Anti-Bacterial Agents/pharmacology
20.
Femina ; 47(11): 824-830, 30 nov. 2019. tab
Article in Portuguese | LILACS | ID: biblio-1046555

ABSTRACT

As infecções do trato urinário (ITUs) afetam cerca de 150 milhões de pessoas por ano e caracterizam-se pela resposta do organismo a uma invasão e multiplicação bacteriana. O tratamento é realizado com antibióticos, mas, devido ao uso indiscriminado, tem-se observado o aumento de resistência bacteriana. Nesse contexto, as plantas medicinais são promissoras, pois possuem baixo custo e fácil acesso, e muitas possuem atividade antimicrobiana. Objetivou-se revisar as principais espécies utilizadas na prática clínica na prevenção e tratamento de ITUs. A utilização da fitoterapia para aliviar sintomas e diminuir a recorrência sintomática das ITUs é uma alternativa válida e promissora, destacando-se a espécie Vaccinium macrocarpon L. (cranberry). Porém, apesar dos avanços e do potencial dessas espécies, há ainda a necessidade de estudos sobre seus respectivos mecanismos de ação. Além disso, a capacitação dos profissionais de saúde para realizar uma prescrição correta, assertiva e segura é essencial.(AU)


Urinary tract infections (ITUs) affect about 150 million people each year and are characterized by the body's response to invasion and bacterial multiplication. Antibiotics are the main therapy used, but due to indiscriminate use, increased bacterial resistance has been observed. In this context, medicinal plants are a promising, low cost and easy access alternative. The aim of this study was to review the main species used in clinical practice in the prevention and treatment of UTIs. The use of herbal medicine to relieve symptoms and reduce symptomatic recurrence of UTIs is a valid and promising alternative, especially Vaccinium macrocarpon L. (cranberry) specie. However, despite the advances and potential of these species, it is necessary to establish their mechanisms of action. Still, the primary training of health professionals to make a correct, assertive and safe prescription is fundamental.(AU)


Subject(s)
Humans , Male , Female , Plants, Medicinal , Urinary Tract Infections/drug therapy , Phytotherapeutic Drugs , Phytotherapy/methods , Signs and Symptoms , Low Cost Technology , Anti-Bacterial Agents
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