Detección de Staphylococcus aureus resistente a meticilina mediante disco de cefoxitina / Detection of methicillin-resistant Staphylococcus aureus by cefoxitin sodium disc

OBJETIVO. Detectar la presencia del Staphylococcus aureus resistente a meticilina en el Hospital Militar Central «Dr. Luis Díaz Soto¼. MÉTODOS. Se utilizó el método de difusión con discos de cefoxitina-30 µg. El período analizado fue entre julio de 2006 y febrero de 2007 y fueron estudiadas 125 cepas Staphylococcus aureus. RESULTADOS. El 73,6 % de cepas identificadas fueron sensibles a la meticilina, y a la mayoría de los antibióticos betalactámicos; 26,4 % de estos eran cepas Staphylococcus aureus resistente a meticilina. En los estafilococos asociados al hospital, el porcentaje de Staphylococcus aureus resistente a meticilina se elevó hasta casi el 45 %. La mayor parte de los aislamientos ocurrieron en la Sala de Quemados y la Unidad de Cuidados Intensivos de Adultos (68 % entre ambos). De las muestras tomadas en el medio hospitalario (25) hubo predominio de la quemadura, la secreción bronquial y las lesiones cutáneas (17); en pacientes ambulatorios (8) fueron obtenidas a partir de lesiones en piel y partes blandas (8). La mayoría de las cepas identificadas como Staphylococcus aureus resistente a meticilina (66,6 %) fueron completamente resistentes a cefoxitina. Ninguno de los estafilococos estudiados presentó resistencia a vancomicina. No se observaron diferencias entre los Staphylococcus aureus resistente a meticilina hospitalarios y los comunitarios en cuanto a sus patrones de resistencia; se comprobaron valores de resistencia elevados para casi todos los antibióticos probados, con la excepción de vancomicina. CONCLUSIONES. El disco de cefoxitina mostró utilidad para detectar Staphylococcus aureus resistente a meticilina y predecir su comportamiento frente a otros antibióticos. Se constató que los Staphylococcus aureus resistente a meticilina identificados fueron extremadamente resistentes.

OBJECTIVE. To detect the presence of Methicillin-resistant Staphylococcus aureus in patients from the «Dr. Luís Díaz Soto¼ Central Military Hospital. METHODS. The 30 µg-cefoxitin diffusion disk method was used. Analysis period was between July, 2006 to February, 2007 and 125 Staphylococcus aureus strains were studied. RESULTS. There was a 73.6 % of methicillin-sensitive of strains and to most of beta-lactamase antibiotics; the 26.4 % were methicillin-resistant Staphylococcus aureus strains. In hospital associated staphylococcus, percentage of above mentioned staphylococcus increased to almost the 45 %. Most of isolations were in Burn Ward and in Adult Intensive Care Unit (68 % for both). From the samples took in hospital environment (25) there was predominance of burns, bronchial secretion and the skin lesions (17); in ambulatory patients (8) samples took were from the skin lesions and soft tissues (8). Most of the Methicillin-resistant S. aureus strains (66.6 %) were Cefoxitin- resistant. No study staphylococcus was Vancomycin-resistant. There were not differences among the hospital Methicillin-resistant S. aureus and the community ones as regards its resistance patterns; we demonstrated high resistance values for almost all the study antibiotics, except the Vancomycin. CONCLUSIONS. Cefoxitin disk was useful to detect the Methicillin-resistant S. aureus and to predict its behavior versus other antibiotics. We verify that above mentioned Staphylococcus were very resistant.

Infecção bacteriana na leishmaniose cutânea: padrão bacteriano e sensibilidade a antibióticos / Bacterial infection in cutaneous leishmaniasis: bacterial pattern and sensitivity to antibiotics

Foi estudada a flora bacteriana em úlceras leishmanióticas, destacando-se o encontro das espécies aeróbicas Staphylococus aureus e Pseudomonas aeruginosa. O estudo da sensibilidade destas espécies a antibióticos mostrou sensibilidade à vancomicina, à amicacina e ao cloranfenicol em 100 por cento dos isolados testados de Staphylococus aureus e à amicacina, à gentamicina e à tobramicina em 100 por cento dos isolados testados de Pseudomonas aeruginosa. Estas espécies foram, em geral, resistentes às penicilinas e à tetraciclina.

The bacterial flora from leishmanial ulcers was studied. The aerobic species Staphylococcus aureus and Pseudomonas aeruginosa were found most frequently. Evaluation of the sensitivity of these species to antibiotics showed that 100 percent of these isolates of Staphylococcus aureus were sensitive to vancomycin, amikacin and chloramphenicol, while 100 percent of the isolates of Pseudomonas aeruginosa were sensitive to amikacin, gentamicin and tobramycin. These species were generally resistant to penicillins and tetracycline.

Distribution of bacteria and drug-resistance to antibiotics in patients with lower respiratory tract infections diseases in RICU / 中国实用内科杂志

Objective To investigate the distribution,the drug-sensitivity tests and drug-resistance of bacteria in patients with lower respiratory tract infections diseases in respiratory intensive care units(RICU).Methods Retrospective study of the clinical data,the distribution and the drug-sensitivity of bacteria of 178 cases with mechanical ventilation in RICU.The drug-sensitivity were examined by Kribry-Bauer(KB)paper method and minimal-inhibitory-concentration(MIC)by agar double dilute method.Results A total of 326 strains bacteria were obtained in 178 patients.Among 326 strains G-bacteria were the most common kinds of bacteria(78.2%);main kinds of the G-bacteria were pseudomonas areuginosa(30.4%)and baumanii(23.0%);fungus was the second commonest kind of bacteria(16.6%).Most of the G+ bacteria were staphycoccus aureus.In 107 cases more than two kinds of bacteria were obtained.The drug sensitivity test in vitro showed that these strains were multiresistant to commonly used antibiotics,and drugs whose sensitive rate was over 70% included meropenem,impienem,cefoperazone/sulbactam,amikacin and piperacillin/tazabactam,the sensibility of vancomycin to G+ bacteria being 100%.Conclusion Pseudomonas areuginosa,baumanii and fungus are the main pathogens of the patients in RICU;meropenem,impienem,cefoperazone/sulbactam,amikacin and vancomycin are effctive antibiotics for treating lower respiratory tract infection in RICU.There is mixed infection by various bacteria,and some strains are multiresistant.We should monitor drug-sensitivity to bacteria dynamic and use antibiotics reasonably.

Clinical and Bacteriological Studies of Urinary Tract Infection in Children

Clinical and bacteriologicaql studies on 133 cases of urinary tract infection who were admitted to the Dept. of Pediatrics, NMC during the period of Jan. 1974 to Jan. 1979 were subjected in this study. The resultes were as follows : 1. Among the total 133 cases, 100 cases(75.2%) were male and 33 cases(24.8%) were female with sex ratio of 3:1. 2. The highest incidence(42.1%) was in children below the age of one year. The rate then decreased with age. 3. Seasonal incidence was relatively high in summer months, but seasonal difference was not significant. 4. Edema, signs of URI, vomiting, hematuria, failure to thrive and feeding problem were common clinical features. 5. Urinalysis disclosed proteinuria in 43 cases(32.3%), hematuria in 36 cases(27.1%) and pyuria in 26 cases(19.6%). 6. Hematological findings showed low hemoglobin in 40 cases(30.0%), leucocytosis in 31 cases(23.3%) and elevated ESR in 42 cases(31.6%). 7. IVP was performed in 13 cases, and 3 cases of them showed abnormal findings. 8. Nephrotic syndrome, acute glomerulonephritis, hyperbilirubinemia and sepsis were the common concurrent illnesses. 9. E. coli predominated as the infecting organisms(36.8%). It was most sensitive to ;gentamycin(83.7%) and cefamezine(77.8%)

Clinical and Bacteriological Studies of Urinary Tract Infection in Children

Clinical and bacteriologicaql studies on 133 cases of urinary tract infection who were admitted to the Dept. of Pediatrics, NMC during the period of Jan. 1974 to Jan. 1979 were subjected in this study. The resultes were as follows : 1. Among the total 133 cases, 100 cases(75.2%) were male and 33 cases(24.8%) were female with sex ratio of 3:1. 2. The highest incidence(42.1%) was in children below the age of one year. The rate then decreased with age. 3. Seasonal incidence was relatively high in summer months, but seasonal difference was not significant. 4. Edema, signs of URI, vomiting, hematuria, failure to thrive and feeding problem were common clinical features. 5. Urinalysis disclosed proteinuria in 43 cases(32.3%), hematuria in 36 cases(27.1%) and pyuria in 26 cases(19.6%). 6. Hematological findings showed low hemoglobin in 40 cases(30.0%), leucocytosis in 31 cases(23.3%) and elevated ESR in 42 cases(31.6%). 7. IVP was performed in 13 cases, and 3 cases of them showed abnormal findings. 8. Nephrotic syndrome, acute glomerulonephritis, hyperbilirubinemia and sepsis were the common concurrent illnesses. 9. E. coli predominated as the infecting organisms(36.8%). It was most sensitive to ;gentamycin(83.7%) and cefamezine(77.8%)