An investigation about chronic prostatitis in ankylosing spondylitis

Abstract Background: Chronic prostatitis has been a common disease reported with high frequency in ankylosing spondylitis (AS) even from decades ago. Infectious (Chlamydia trachomatis) or non-infectious (uric acid) prostatitis can hypothetically trigger vertebral inflammation in AS. This study aimed to assess the features of chronic prostatitis in patients with AS compared to healthy controls. Methods: A cross-sectional study including male patients with AS and healthy controls who agreed to undergo a prostate examination was conducted. Structured clinical interviews, prostate physical examinations, and cytological, biochemical, and microbiological tests on urinary samples collected before and after standardized prostatic massage (pre- and post-massage test) were performed. Results: Ninety participants (45 AS patients, mean age: 52.5 ± 10.0 years, with longstanding disease, 12.4 ± 6.9years, and 45 controls, mean age: 52.8 ± 12.1 years) were included. National Institutes of Health - Chronic Prostatitis Symptom Index (NIH-CPSI) scores were similar in the AS and control groups (4.0 [1.0-12.0] vs. 5.0 [1.0—8.5], p = 0.994). The frequencies of symptoms of chronic prostatitis (NIH-CPSI Pain Domain ≥4) were also similar in both groups (23.3% vs. 22.7%, p = 0.953). Results of polymerase chain reaction tests for Chlamydia trachomatis were negative in all tested urinary samples, and uric acid concentrations and leukocyte counts were similar in all pre- and post-massage urinary samples. Conclusions: In this study, chronic prostatitis occurred in male patients with AS, but its frequency and characteristics did not differ from those found in the healthy male population of similar age.

Carbapenem-resistant Pseudomonas aeruginosa: clonal spread in southern Brazil and in the state of Goiás

This study evaluated the clonal spread of carbapenem-resistant P. aeruginosa producing SPM-1 type metallo-β-lactamase (MBL), at the university hospital of Florianópolis, Santa Catarina, Brazil, compared to an epidemic clone previously reported, as well as strains collected in other three Brazilian states. Among the isolates, 17 (62 percent) were clonal and highly related to strains from other regions of Brazil. Six clonal strains harbored the blaSPM-1 gene. The finding of a unique SPM-1 producer clone suggests that its dissemination has contributed to the high resistance to carbapenems in Brazilian hospitals.

Intrahospital spread of carbapenem-resistant Pseudomonas aeruginosa in a University Hospital in Florianópolis, Santa Catarina, Brazil / Disseminação Intrahospitalar de Pseudomonas aeruginosa em Hospital Universitário de Florianópolis, Santa Catarina, Brasil

INTRODUCTION: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) has been isolated with increasing frequency in Brazilian hospitals. Since June 2003, its detection in a teaching hospital in the city of Florianópolis, Brazil, has increased. This study aimed to investigate the minimal inhibitory concentration (MIC), presence of Metallo-β-lactamase (MβL) and a possible clonal relationship among the isolates. METHODS: The study included 29 CRPA and seven isolates with reduced susceptibility. The MIC was determined by agar-dilution. Detection of MβL was performed by Double Disk Sinergism (DDS) and Combined Disk (CD). The MβL gene was verified by PCR and nucleotide sequence analysis. Epidemiological typing was performed by pulsed-field gel electrophoresis. RESULTS: Among the 29 carbapenem-resistant isolates, polymyxin B presented 100 percent susceptibility and piperacillin/tazobactam 96.7 percent. Seventeen (62 percent) strains were verified as clonal (A clone) and among these, six isolates indicated phenotypically positive tests for MβL and harbored the blaSPM-1 gene. The first CRPA isolates were unrelated to clone A, harbored blaIMP-16 and were phenotypically positive only by CD. CONCLUSIONS: The spread of a high-level of resistance clone suggests cross transmission as an important dissemination mechanism and has contributed to the increased rate of resistance to carbapenems. This study emphasizes the need for continuous surveillance and improved strategies.

INTRODUÇÃO: O isolamento de Pseudomonas aeruginosa resistente aos carbapenêmicos (PARC) tem sido cada vez mais frequente nos hospitais brasileiros. O presente estudo investigou a concentração inibitória mínina (CIM), a presença de metalo-β-lactamases (MβL), e uma possível relação clonal entre PARC isoladas entre junho de 2003 a junho de 2005, em um hospital escola na cidade de Florianópolis, Brasil. MÉTODOS: O estudo incluiu 29 PARC e sete isolados com suscetibilidade reduzida. A CIM foi determinada por diluição em ágar. A detecção de MβL foi realizada por sinergismo de duplo disco (SDD) e disco combinado (DC). Genes para MβL foram pesquisados por PCR e confirmados pela análise da sequência de nucleotídeos. A tipagem epidemiológica foi realizada por gel de eletroforese em campo pulsátil. RESULTADOS: Entre os 29 isolados resistentes aos carbapenêmicos, 100 por cento apresentaram suscetibilidade a polimixina B, e 96,7 por cento a piperacilina/tazobactam. Dezessete (62 por cento) destes isolados pertenciam a um mesmo clone (clone A); entre estes, seis isolados apresentaram testes fenotípicos positivos para MβL e carreavam o gene blaSPM-1. O primeiro isolado PARC não foi relacionado ao clone A, carreava o gene blaIMP-16 e foi fenotipicamente positivo somente por DC. CONCLUSÕES: A propagação de um clone com alto nível de resistência sugere a transmissão cruzada como um importante mecanismo de disseminação e tem contribuído para o aumento nos níveis de resistência aos carbapenêmicos. Este estudo enfatiza a necessidade de vigilância contínua e melhoramento nas estratégias de controle de infecção nesta instituição.