Bacterias nosocomiales emergentes: Infección endovascular por Elizabethkingia meningoseptica / Emerging nosocomial bacteria: Endovascular infection by Elizabethkingia meningoseptica

Elizabethkingia meningoseptica es un bacilo gram negativo no fermentador, no móvil, y oxidasa positivo, ampliamente distribuido en la naturaleza pero poco frecuente en humanos, en quienes se considera un patógeno oportunista, actualmente denominado emergente. En el ambiente hospitalario se ha encontrado en superficies húmedas y en equipos médicos, soluciones que habitualmente se utilizan de forma intravenosa, y en medicamentos de reconstitución. Puede causar infección en personas inmunocomprometidas o con enfermedades debilitantes concomitantes. Además, posee enzimas de resistencia frente a los antibióticos prescritos usualmente contra las bacterias gram negativas. Se presenta un caso de bacteriemia por E. meningoseptica en un paciente con antecedente de enfermedad renal crónica, quien recibía tratamiento hemodíalítico 3 veces por semana, desde hace 2 años, al ingreso se documentó infección del sitio de inserción del catéter venoso central, y posteriormente se aisló en los hemocultivos periféricos el crecimiento de la bacteria E. meningoseptica, el paciente cumplió tratamiento con trimetroprim-sulfametoxazol por 14 días con adecuada evolución clínica, sin complicaciones...(AU)

Elizabethkingia meningoseptica is a non fermenter bacilli gram negative, non-mobile, and positive oxidase, widely distributed in nature but rare in humans, in whom it is considered an opportunistic pathogen, now called emerging. In the hospital environment it was found on wet surfaces and medical equipment, solutions usually used intravenously, and drug reconstitution. It can cause infection in immunocompromised or with concomitant debilitating diseases people. It also has resistance to enzymes usually prescribed antibiotics against gram negative bacteria. A case of bacteremia is presented by E. meningoseptica in a patient with a history of chronic kidney disease, who received hemodialysis 3 times a week, for 2 years, entry site infection insertion of central venous catheter was documented and later was isolated from peripheral blood cultures the growth of bacteria E. meningoseptica, the patient completed treatment with trimethoprim-sulfamethoxazole for 14 days with adequate clinical course without complications...(AU)

Absceso cerebral por nocardia SP en paciente con anemia hemolítica reporte de un caso / Cerebral abscess due to nocardia SPP in a patient with hemolytic anemia report of a case

Las infecciones por Nocardia no son comunes para humanos inmunocompetentes la mayoría de casos es reportada en pacientes inmunosupresos, usualmente la mayoría de estos casos se reportan a nivel pulmonar y tejidos blandos. Los abscesos por Nocardia son usualmente poco comunes reportando aproximadamente el 1 a 2% del total de abscesos cerebrales. A continuación, se describe el caso de una paciente con antecedente de Anemia Hemolítica a quien se diagnosticó absceso cerebral por Nocardia...(AU)

Multidrogas resistencia en pacientes con tuberculosis diagnosticada microbiológicamente en el Hospital Roosevelt de la ciudad de Guatemala en el período 2004-2008 / Multidrug resistance in tuberculosis patients diagnosed microbiologically at Roosevelt Hospital in the city of Guatemala in 2004-2008

Objetivo: Evaluar las tasas de resistencia de Mycobacterium tuberculosis a los medicamentos antituberculosos de primera línea, en pacientes del Hospital Roosevelt. Material y Métodos: se analizaron las cepas de Mycobacterium tuberculosis aisladas de los años 2004 al 2008, a todas las cepas se les realizó pruebas de identificación y pruebas de sensibilidad por medio del método de Cannetti y Grosset, utilizando las drogas de primera línea con los respectivos controles de crecimiento y control de resistencia con una cepa conocida por ser MDR...

Meningitis and pneumonia in Guatemalan children: the importance of Haemophilus influenzae type b and Streptococcus pneumoniae

OBJECTIVE: To determine the epidemiology of Haemophilus influenzae type b (Hib) and Streptococcus pneumoniae invasive infections in hospitalized Guatemalan children. This is an important issue since Hib vaccine has not been incorporated into the routine immunization program in Guatemala and information from hospital records in 1995 indicated a low incidence of Hib and S. pneumoniae as causes of meningitis and invasive infections. METHODS: Children who were hospitalized in Guatemala City with clinical signs compatible with bacterial infections were evaluated for evidence of Hib or S. pneumoniae infection. Normally sterile body fluids were cultured, and antigen detection was performed on cerebrospinal fluid (CSF) and pleural fluid. RESULTS: Of 1 203 children 1-59 months of age hospitalized over a 28-month period, 725 of them (60.3 percent) had a primary diagnosis of pneumonia, 357 (29.7 percent) of meningitis, 60 (5.0 percent) of cellulitis, and 61 (5.1 percent) of sepsis and other conditions. Hib was identified in 20.0 percent of children with meningitis and S. pneumoniae in 12.9 percent. The average annual incidence of Hib meningitis was 13.8 cases per 100 000 children under 5 years of age, and 32.4 percent of meningitides caused by Hib and 58.7 percent of S. pneumoniae meningitides occurred prior to 6 months of age. Case fatality rates were 14.1 percent, 37.0 percent, and 18.0 percent, respectively, for children with Hib, S. pneumoniae, and culture-negative and antigen-negative meningitis. Prior antibiotic therapy was common and was associated with significant reductions in CSF-culture-positive results for children with other evidence of Hib or S. pneumoniae meningitis. CONCLUSIONS: Improvements in case detection, culture methods, and latex agglutination for antigen detection in CSF resulted in identification of Hib and S. pneumoniae as important causes of severe disease in Guatemalan children. Using a cutoff of > 10 white blood cells per cubic millimeter in CSF would improve the sensitivity for detection of bacterial meningitis and help estimate the burden of bacterial meningitis in Guatemala and other developing countries.