RESUMO
Background: There is little information available in Chile on the distribution of Enterococcus spp in waste water and its implications in transmission of antibiotic resistance through the water cycle. Enterococcus spp are common in nosocomial infections and may spread antibiotic resistance through the food chain. Aim: To determine the presence of antibiotic resistant Enterococcus spp in the sewage of Antofagasta, Chile. Material and Methods: Samples of sewage from two sewage treatment plants and from the Public Hospital of Antofagasta collector were obtained. Enterococcus spp were isolated on m-Enterococcus agar containing ampicillin, vancomycin and streptomycin. The isolates were identified and subjected to biochemical typing (PhPlate). Minimal inhibitory concentration determination was performed by agar dilution technique. Results: High counts of resistant Enterococcus spp were found on the streptomycin plates, lower on ampicillin and very low on vancomycin plates. A total of 63 Enterococcus spp strains were typed and the identification showed 5 different species; E faecalis (65%), E faecium (14%), E hirae (13%), E durans (6%) and E gallinarum (2%). The typing revealed a high diversity among the isolates. Two biochemical phenotypes were predominant, C1 (21 strains) and C6 (7 strains). Both were highly resistant to gentamycin and streptomycin; moderately resistant to ampicillin, cloramphenicol, tetracycline and ciprofloxacin, and with intermediate susceptibility to vancomycin. Both phenotypes were found in the sewage of the hospital collector and in the treatment plants. Conclusions: In the sewage of Antofagasta we found dominating phenotypes of multiresistant Enterococcus spp. Sewage could be an important way of transmission of these microorganisms.
Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana , Enterococcus/efeitos dos fármacos , Esgotos/microbiologia , Microbiologia da Água , Chile , Farmacorresistência Bacteriana/genética , Enterococcus/isolamento & purificação , Gentamicinas/farmacologia , Testes de Sensibilidade Microbiana , Estreptomicina/farmacologia , Vancomicina/farmacologia , Eliminação de Resíduos LíquidosRESUMO
Los pacientes que cursan tromboembolismo, dependiendo de su severidad, pueden recibir variados tratamientos no exentos de efectos adversos. Existe, por lo tanto, la necesidad de estratificar riesgo -magnitud- mortalidad con criterios que le permitan al clínico tomar las mejores decisiones. En este artículo se pretende establecer un sistema de aproximación al tromboembolismo pulmonar de acuerdo a la información hasta ahora disponible.
Assuntos
Humanos , Masculino , Adulto , Feminino , Ecocardiografia , Embolia Pulmonar/diagnóstico , Peptídeo Natriurético Encefálico , Troponina C , Troponina I , Troponina T , Fibrinolíticos/uso terapêutico , Eletrocardiografia , Embolia Pulmonar/fisiopatologia , Embolia Pulmonar/mortalidade , Heparina/uso terapêutico , Biomarcadores , Índice de Gravidade de DoençaRESUMO
Os autores relatam tres casos de portadores de hipertensao renovascular estudados por metodos invasivos e nao invasivos e submetidos a intervencao cirurgica corretiva com excelentes resultados