Perfil de resistencia genotípica y fenotípica presente en bacterias aisladas a partir de fómites en Armenia, Quindío-Colombia período junio-julio 2019 / Genotypic and phenotypic resistance profile present in bacteria isolated from fomites in Armenia, Quindío-Colombia period June-July 2019

Resumen Introducción: La antibiótico-resistencia es un fenómeno por el cual las bacterias logran sobrevivir al tratamiento con antimicrobianos; con incidencia en ambientes intra y extrahospitalarios como: fuentes hídricas, sector agrario/ganadero y fómites. Objetivo: Describir bacterias presentes en fómites de alta circulación en una región centro-occidental de Colombia junto a su perfil de sensibilidad fenotípica y presencia de genes para betalactamasas tipo TEM-full, OXA-3 y SHV-full. Metodología: Se aislaron cepas bacterianas de billetes, pasamanos de escaleras eléctricas y botones de cajeros automáticos; se evaluó su perfil de sensibilidad fenotípica por medio de concentración mínima inhibitoria-técnica automatizada/Vitek2® y genes para betalactamasas tipo TEM-full, OXA-3 y SHV-full mediante PCR convencional. Resultados: Se obtuvo 30 aislados; Acinetobacter baumannii complex, fue la más común; el fómite con mayor aislados y resistencia fueron los billetes; el 53% portó al menos uno de los genes estudiados. Se identificaron bacterias gramnegativas con resistencia frente a: Imipinem, Piperacilina/Tazobactam, Colistina, Ceftazidima, Tigeciclina y Ceftriaxona; bacterias grampositivas con resistencia frente a: Quinupristina/Dalfopristina, Minociclina, Tetraciclina, Teicoplanina, Nitrofuratoina, Oxacilina, Clindamicina, Trimetropina-sulfametoxazol, y Minociclina. Conclusión: Teniendo en cuenta la circulación de cepas con estas resistencias, es importante la educación en la comunidad para evitar la adquisición o propagación de infecciones por manipulación inadecuada de fómites.

Abstract Introduction: Antibiotic-resistance is a phenomenon by which bacteria manage to survive antimicrobial treatment; with incidence in intra and extra hospital environments such as: water sources, agricultural / livestock sector and fomites. Aim: To describe bacteria present in high circulation fomites in a central-western region of Colombia, with their phenotypic sensitivity profile and presence of genes beta-lactamases (TEM, OXA3 and SHV). Methodology: We isolate bacterial strains from banknotes, escalator handrails and ATM buttons. We evaluated its phenotypic sensitivity profile by minimal inhibitory concentration automated technique using Vitek 2® and presence of genes for beta-lactamases type TEM-full, OXA-3 and SHV-full by conventional PCR. Results: A total of 30 isolates were obtained; Acinetobacter baumannii complex, was the most common; banknotes were the form with the highest number of isolates and resistance. Of the total isolates, 53% carried at least one of the genes studied. Phenotypically, gram-negative bacteria were identified with resistance against: Imipinem, Piperacillin / Tazobactam, Colistin, Ceftazidime, Tigecycline and Ceftriaxone; Gram-positive bacteria with resistance to: Quinupristin / Dalfopristin, Minocycline, Tetracycline, Teicoplanin, Nitrofuratoin, Oxacillin, Clindamycin, Trimethropine-sulfamethoxazole, and Minocycline. Conclusion: Taking into account the circulation of strains with these resistances, it is important to educate the community to avoid the acquisition or spread of infections due to the inappropriate handling of this type of inanimate elements.

Incidência de infecções primárias na corrente sanguínea em uma UTI neonatal / Incidence of primary bloodstream infections in a neonatal intensive care UNIT

As infecções primárias da corrente sanguínea são umas das principais causas de morbimortalidade intra-hospitalar. Além da grande responsabilidade sobre as mortes perinatais, estas são as principais infecções em Unidade de Terapia Intensiva Neonatal (UTI neonatal) e estão associadas a altos custos hospitalares, representando assim um grave problema de saúde pública. O objetivo é identificar a incidência de Infecções Primárias da Corrente Sanguínea (IPCS) em uma UTI neonatal de uma unidade hospitalar do Estado de Santa Catarina, Trata-se de um estudo descritivo retrospectivo, de abordagem quantitativa, tendo por base os dados coletados pela Comissão de Controle de Infeções relacionadas à assistência à saúde (CCIH) . Esta caracteriza as infecções com base nos Critérios Diagnósticos de Infecções Relacionadas à Assistência à Saúde da Agência Nacional de Vigilância Sanitária (ANVISA) as IPCS ocorridas na UTI neonatal nos anos de 2014 a 2015. Ocorreram neste período um total de 30 casos, sendo que em ambos os anos a maioria dos casos de IPCS ocorreram em pacientes do sexo feminino e com mais de 1.500g de peso ao nascer. A caraterização das IPCS laboratorial foi positiva em 88,5% e dentre as bactérias isoladas, apenas 4 (44,44%) no ano de 2014 foram classificadas como multirresistentes e não foram encontradas estas no ano de 2015. As bactérias mais comumente isoladas foram Staphylococcus aureus (41,6%) e Staphylococcus coagulase negativa (37,5%). Sendo que o desfecho dos casos foi predominantemente alta hospitalar.

The primary bloodstream infections are a major cause of in-hospital mortality. Besides the great responsibility on perinatal deaths, these are the main infections in neonatal ICUs and are associated with high hospital costs, thus representing a serious public health problem. The aim of this article is to analyze the incidence of Primary Blood Stream Infections in the Intensive Care Unit of a hospital in the state of Santa Catarina, as well as identify the most prevalent bacteria in IPCS and its sensitivity to antibiotics. This is a retrospective descriptive study with a quantitative approach, based on data collected by the Commission of Hospital Infection Control (CCIH) of Tereza Ramos Hospital (HTR), which characterized the IPCS occurred in the Neonatal Intensive Care Unit of the same hospital in the years 2014 and 2015. Occurred in this period a total of 30 cases, and in both years the majority of cases of IPCS occurred in female patients and over 1.500g and the predominant outcome was discharged. Blood cultures were positive in 88.5% and among the bacteria isolated, only 4 (44.44%) in 2014 were classified as multirresistentes. As most commonly isolated bacteria were Staphylococcus aureus (41.6%) and staphylococcus coagulase negative (37.5%). It is understood finally that the characteristics of the patients in our ICU IPCS follows specific pattern and increasing values, showing that are required targeted and effective measures to reduce the number of infections at our institution.

Perfil de prescrição de antimicrobianos nas unidades básicas de saúde conveniadas com a universidade de Itaúna/MG / Antimicrobial prescription profile in the basic health units agreed with the university of Itaúna/MG

INTRODUÇÃO: O uso abusivo de antibacterianos está intimamente relacionado ao desenvolvimento de resistência bacteriana, considerada, atualmente, um problema de saúde pública mundial. Segundo a Organização Mundial de Saúde, em 2001, mais da metade das prescrições de antimicrobianos foram inapropriadas e dois terços de sua utilização foram feitas sem prescrição médica. Assim, o uso racional desse medicamento requer uma seleção criteriosa e bom senso clínico do prescritor. OBJETIVOS: Analisar o perfil de prescrição de antimicrobianos nas Unidades Básicas de Saúde da Família (UBSF) do município de Itaúna-MG, conveniados com a Universidade de Itaúna (UIT) e contribuir para que futuras intervenções possam ser conduzidas promovendo do uso racional dos antimicrobianos na atenção primária. MÉTODOS: Estudo transversal de prontuários médicos de pacientes atendidos nas UBSF de Itaúna/MG conveniadas com a UIT, realizado entre março de 2013 e março de 2014, para os quais foram prescritos antibióticos. RESULTADOS: A classe de antimicrobianos mais prescrita foi a das penicilinas seguido pelas quinolonas e macrolídeos. Quanto à duração do tratamento, o período de cinco a dez dias foi observado na maioria das prescrições. As principais indicações clínicas foram infecção das vias aéreas superiores não especificadas, amigdalite, otite, sinusite, infecção do trato urinário entre outros. A solicitação de culturas foi realizada em apenas 5,5% dos casos. CONCLUSÃO: A análise do perfil das prescrições revelou a necessidade de reciclagem da equipe e adoção de protocolos clínicos. Tais medidas permitirão a uniformização das condutas, otimizando as prescrições e reduzindo o risco do uso inapropriado de antimicrobianos. (AU)

Introduction: The overuse of antibacterials is closely related to the development of bacterial resistance, currently considered a problem of public health worldwide. According to the World Health Organization, in 2001 over half of the antimicrobial prescriptions were inappropriate and two thirds of its use were made without prescription. Thus, the rational use of this drug requires careful selection and clinical judgment of the prescriber. Objectives: To analyze the antimicrobial prescription profile in the Basic Health Units of family of Itaúna-MG, that have agreements with the University of Itaúna (UIT) and contribute to future interventions that can be conducted to promote the rational use of antimicrobials in primary care. Methods: Cross-sectional study of medical records of patients treated in Basic Health Units of family Itaúna / MG with agreement with the UIT, held between March 2013 and March 2014, for which antibiotics were prescribed. Results: The most prescribed class of antimicrobials was the penicillins followed by quinolones and macrolides. About the duration of treatment, five to ten days was observed in the majority of prescriptions. The main clinical indications were infection of the upper airways unspecified, tonsillitis, otitis, sinusitis, urinary tract infection, among others. The request of cultures was performed in only 5.5% of cases. Conclusion: The analysis of the profile of prescriptions revealed the need for retraining of staff and adoption of clinical protocols. These measures will enable to uniform the procedures, optimizing the regulations and reducing the risk of inappropriate use of antimicrobials. (AU)

Analysis in drug resistance and distribution of Streptococcus pneumonia infection in one area / 国际检验医学杂志

Objective To investigate the dynamic changes of infection distribution ,current resistance situation of Streptococcus pneumoniae(SP) in Sichuan area for the guidance of clinical therapy of SP .Methods The clinical result of SP from January 2013 to June 2016 were collected in our hospital .The age ,distribution department ,sample type ,the season and drug susceptibility results were analyzed .Results Infections caused by SP was prevalent in spring and winter ,and which mainly occurred in the infant and the elderly .The number of SP was maximum in the pediatrics ,and the detection rate was above 59% .Clinical isolates of SP mainly were detected from sputum ,followed by the blood .Penicillin G‐resistant SP strains were isolated more and more from 2013 to 2016 in Si‐chuan area .Erythromycin(E) ,Tetracycline(TC) and Trimethoprim/Sulfamethoxazole(SXT) had the higher resistance .No drug‐re‐sistant strains of Vancomycin(VA) and Linezolid(LZD) were detected .Levofloxacin(LEV) and Moxifloxacin(MXF) were more sensitive ,being more 95% ,and the sensitive rate of Chlormycetin(CL) also was over 87% .Conclusion There is an upward trend to detect the penicillin G‐resistant SP strains .Using of E ,TC and SXT should be managed ,because of its higher resisitance rate .How‐ever ,LEV ,MXF ,VA and LZD could still be used by clinical doctors for its higher sensitive rate .

Distribution and drug resistance of pathogens for bacterial infection after lung transplantation / 中华器官移植杂志

Objective To analyze the distribution and drug resistance of pathogens for bacterial infection after lung transplantation,so as to provide evidence for clinical prophylactic strategies postoperation and reasonable use of antibiotics.Method The bacterial distribution and drug resistance of 81 recipients after lung transplantation in our hospital were retrospectively analyzed from May 2009 to October 2012.The VITEK-32 full-automatic microbial identification system (Biomerieux,France)and its supplementary reagent were used for bacterial identification and drug sensitive test.The data were statistically analyzed by using the software SPSS 13.0.Result There were 67 cases of bacterial infection in the 81 recipients after lung transplantation and the infection rate was 82.72％ (67/81).The infection was caused by one kind of bacteria in 20 patients,two kinds of bacteria in 23 patients and multiple bacteria in 24 patients.157 strains pathogenic bacteria were produced,and the grampositive bacilli and the gram-negative bacilli accounted for 12.74％ and 87.26％ respectively.The most common pathogens for the bacterial infection were Acinetobacter baumannii,Klebsiella pneumoniae,Pseudomonas aeruginosa,Stenotrophomonasmaltophilia,Escherichia coli and Staphylococcus aureus.Most of the bacterial infections occurred in the early period (≤1 month) after lung transplantation and most non-fermentative bacterial pathogens were resistant to multi-antibiotics.Conclusion The bacterial infection rate is high after lung transplantation.The rational use of antibiotics in clinical practice should be adjusted according to the bacterial distribution and drug resistance.

Distribution and drug resistance of bacterial pathogens isolated from peritonsillar abscess during ;2010-2014 in Wenzhou / 中华临床感染病杂志

Objective To investigate the distribution and drug resistance of bacterial pathogens isolated from peritonsillar abscess .Methods Data on bacterial pathogens isolated from peritonsillar abscess in Wenzhou Central Hospital from January 2010 to December 2014 were retrospectively analyzed .Strains were identified with Vitek 32 identification system and the drug susceptibility test was performed with K-B method.Chi-square test for linear trend was performed to reveal the changes of distribution and drug resistance of the strains .Results A total of 2 864 bacterial strains were isolated in five years , in which 1 786 strains were Gram-negative bacilli (62.4%), and 1 078 (37.6%) strains were Gram-positive cocci. The positive rate of Gram-negative bacilli was on the rise during year 2010-2014 (χ2 =84.74, P<0.01), and the top three Gram-negative bacilli were Pseudomonas aeruginosa, Acinetobacter baumannii and Haemophilus influenzae, which accounted for 72.5%(1 295/1 786) of the total Gram-negative strains, and the positive rates of first two bacilli were on the rise (χ2 =83.75 and 24.74, P<0.01).Gram-positive cocci were mainly Staphylococcus aureus and Hemolytic streptococcus, which accounted for 83.2% ( 897/1 078) of the total Gram-positive strains.Resistance rates of Pseudomonas aeruginosa to ceftazidime, cefoperazone, piperacillin/tazobactam were on the rise (χ2 =16.17, 13.48 and 11.44, P<0.05), while resistance rates to gentamicin and amikacin were on the decline (χ2 =16.54 and 16.63, P <0.05). Resistance rates of Acinetobacter baumannii to ceftazidime, cefoperazone/sulbactam and piperacillin/tazobactam were on the rise (χ2 =12.52, 10.85 and 14.14, P<0.05).Resistance rates of Haemophilus influenzae to ampicillin were on the rise (χ2 =10.21, P<0.05), and the positive rate of β-lactamase producing strains was also on the rise (χ2 =10.38, P<0.05).Resistance rates of Staphylococcus aureus to cefazolin and methicillin were on the rise (χ2 =15.44 and 12.53, P<0.05), but no vancomycin resistant strain was found .Hemolytic streptococcus were sensitive to all commonly used antibiotics .Conclusions Peritonsillar abscess in Wenzhou Central Hospital is mainly induced by Gram-negative bacilli infection . Pseudomonas aeruginosa, Acinetobacter baumannii and Staphylococcus aureus are the top three bacterial pathogens , and are highly resistant to most antibiotics .

Comparando inativação fotodinâmica e antimicrobianos / Photoinactivation versus antimicrobial agents

O aparecimento de uma grande variedade de micro-organismos patogênicos resistentes aos antimicrobianos tem resultado tanto no aumento do índice de doenças quanto no aumento do índice de mortalidade, ambos provocados por infecções facilmente tratadas no passado. Assim, tornou-se urgente a necessidade de desenvolver novos procedimentos de intervenção a fim de promover a inviabilização do crescimento microbiano. A Inativação Fotodinâmica de micro-organismos é uma alternativa promissora no combate de infecções localizadas de micro-organismos. Basicamente esse mecanismo envolve a combinação sinérgica de um fotossensibilizador, oxigênio molecular e luz visível de comprimento de onda adequado para produzir espécies reativas de oxigênio, que causam oxidação dos componentes da célula levando-a à morte. A principal vantagem dessa técnica é o fato de não haver desenvolvimento de resistência ao tratamento pelos micro-organismos, devido ao grande número de alvos possíveis por parte dos radicais de oxigênio. Este trabalho faz uma comparação entre inativação fotodinâmica de micro-organismos e a ação dos antimicrobianos.

The appearance of a large variety of antimicrobial-resistant pathogenic microorganisms has led to increased rates of disease and mortality caused by infections that were easily treated in the past. Hence,338Fotoinativação versus antimicrobianosRev Ciênc Farm Básica Apl., 2012;33(3):331-340there is an urgent need to develop new procedures to prevent microbial growth. Photodynamic inactivation of microorganisms is a promising alternative way to fight localized microbial infections. This technique, basically, involves the synergistic combination of a photosensitizer, molecular oxygen and visible light of an appropriate wavelength, to produce highly reactive oxygen species that lead to the oxidation of several cell components and to cell inactivation. The main advantage of the technique is that, given the existence of multiple targets, there is no development of resistance. This paper aims to compare the photodynamic inactivation of microorganisms and the action of antibiotics.

Drug Sensitivity Test of Mycoplasma in Female Genital Tract Infection:Analysis of 5 177 Cases / 中国药房

OBJECTIVE:To study female mycoplasma infection and the drug sensitivity test of mycoplasma. METHODS:Ureaplasma urealyticum(Uu)and mycoplasma hominis(Mh)of cervical secretions sampled from 5 177 female genital infection cases in our hospital were identified by cultivation,and resistance to antibiotics for them was also detected. RESULTS:Of 5 177 infection cases,mycoplasms were cultured from 2 816 specimens with total positive rate of 54.39%. Among them,there were 2 457 cases of Uu infection(47.46%),51 cases of Mh infection(0.99%)and 308 cases of mixed infection(5.95%). The highest susceptibilities of 2 816 strains of mycoplasma to antibiotic were azithromycin,josamycine and klinomycin. The highest drug resistance rates of mycoplasma were cillimycin. CONCLUSION:Rational use of drugs based on drug sensitivity test is of importance to prevent the production of drug-resistence mycoplasma.