RESUMO
Debido a su uso por humanos y para preservar la salud pública, los ambientes marinos recreacionales, deberían cumplir requisitos de calidad fisico-química y microbiológica. Sin embargo, actividades antropogénicas, tales como agricultura, ganadería, industriales, turísticas y domésticas, pueden descargar aguas servidas en playas marinas. La metodología vigente para evaluar la carga bacteriana de aguas recreacionales, no pareciera satisfactoria, particularmente en la detección de microorganismos patógenos debido a la presencia, en aguas marinas, de bacterias viables pero no cultivables (VBNC). Este estudio evaluó la carga bacteriana de aerobios mesófilos, coliformes totales/fecales y enterococos, en playas de Chichiriviche, Falcón, Venezuela y el efecto de concentraciones de agua marina sobre las densidades bacterianas. Las determinaciones se efectuaron en agar nutritivo, Mac Conkey y KF, preparados con agua destilada (MAD) o con agua de mar 10% v/v, (MAM). La carga bacteriana se incrementó entre 20 y 47 veces cuando los medios de cultivo se suplementaron con agua de mar. Las diferencias en las cargas bacterianas entre MAD y MAM, para aerobios mesófilos, coliformes totales y fecales fueron estadísticamente significativas (p≤0,05). El oxígeno disuelto y pH, en ambos medios presentaron valores permisibles.
Due to their use by humans and to preserve public health, recreational marine environments should fulfill physico-chemical and microbiological quality prerequisites. Nevertheless, anthropogenic activities such as agriculture, cattle raising, industrial, touristic and domestic, can discharge contaminated water at marine beaches. The present methods for evaluating the bacterial load of recreational waters does not appear satisfactory, especially concerning the detection of pathogenic microorganisms due to the presence, in marine waters, of viable but not cultivable bacteria (VNCB). This study evaluated the bacterial load of mesophilic aerobials, total and fecal coliforms, and enterococci at the Chichiriviche beaches, Falcon State, Venezuela, and the effect of marine water concentrations over the bacterial densities. The determinations were done in nutrient, Mac Conkey and KF agar prepared with distilled water (MAD) or with sea water (MSW). The bacterial load increased between 27 and 47 times when the culture media were supplement with sea water. The differences of the bacterial loads between MAD and MSW for mesophilic aerobials, total and fecal coliforms were statistically significant (p≤0.05). Dissolved oxygen and pH presented permissible values in both media.
RESUMO
A case of meningitis due to Staphylococcus warneri in a patient with a hyperinfection with Strongyloides stercoralis possibly associated with rituximab treatment for mantel cell lymphoma is reported for the first time in the literature. The patient was a 59-year-old woman, with a 3-year history of an apparently well controlled lymphoma after treatment with chemotherapy-immunotherapy and then immunotherapy alone, and diagnosis of strongyloidiasis. Meningitis was diagnosed by cerebrospinal fluid culture and tested with an automated plate system. The patient was successfully treated with vancomycin; although fever and productive cough persisted. Severe gastrointestinal symptoms and pneumonia developed three weeks later. Hyperinfection syndrome by S. stercoralis was diagnosed, with abundant larvae in feces and expectoration.
Caso de meningite por Staphylococcus warneri em paciente com hiperinfecção com Strongyloides stercoralis, possivelmente associada com tratamento de rituximab para linfoma de células do manto é relatada pela primeira vez na literatura. A paciente, mulher de 59 anos com história de três anos de linfoma aparentemente bem controlado com tratamento com quimioterapia-imunoterapia e, em seguida, somente imunoterapia e diagnóstico de estrongiloidíase. Meningite foi diagnosticada por cultura do líquido cefalorraquidiano e testada com sistema automatizado de placa. A paciente foi tratada com sucesso com vancomicina, embora a febre e a tosse produtiva não tenham desaparecido. Após graves sintomas gastrointestinais a paciente desenvolveu pneumonia três semanas mais tarde. Síndrome de hiperinfecção por S. stercoralis foi diagnosticada, com larvas abundantes nas fezes e expectoração.