Contaminação de halos doadores córneo-esclerais em ceratoplastia penetrante no Hospital de Clínicas de Porto Alegre / Positive corneoscleral rim culture in penetrating keratoplasty at the Porto Alegre Clinical Hospital

OBJETIVOS: Avaliar a incidência de positividade de culturas de halos doadores córneo-esclerais preservados em Optisol GS, identificar os patógenos envolvidos, a sensibilidade dos mesmos à gentamicina e a ocorrência de infecções em olhos receptores. MÉTODOS: Foram analisadas retrospectivamente 163 culturas de halos córneo-esclerais cujos botões corneanos foram utilizados em transplantes de córnea no Hospital de Clínicas de Porto Alegre entre janeiro de 2001 e janeiro de 2003. Os halos foram divididos em dois segmentos, metade inoculada em meio Sabouroud e a outra metade em tioglicolato, com posterior semeadura em ágar-sangue, ágar-chocoloate e meio de MacConkey, conforme necessidade para identificação dos patógenos. Os prontuários dos pacientes receptores foram revisados. RESULTADOS: Dos 163 halos analisados, 11 apresentaram culturas positivas, correspondendo a 6,7 por cento do total. Destes, quatro foram por Staphylococcus epidermidis, um por Staphylococcus aureus, um por Serratia sp, um por Pseudomonas aeruginosa e os outros quatro por diferentes subtipos de Candida (dois por Candida sp, um por Candida albicans e um por Candida parapapilosis). No antibiograma, todas as bactérias apresentaram-se resistentes à gentamicina. Nenhum olho que recebeu córnea com cultura positiva apresentou infecção após a cirurgia. CONCLUSÕES: Baixos índices de positividade de cultura de halos utilizados em transplantes de córnea no Hospital de Clínicas de Porto Alegre foram encontrados. Os patógenos mais freqüentemente identificados não apresentam boa cobertura pelos antimicrobianos presentes nos meios de preservação. A cultura de halos corneanos é recomendada para auxílio no tratamento de possível infecção ocular pós-cirúrgica.

PURPOSE: To determine the incidence of positive corneoscleral rim cultures preserved in Optisol GS medium, to identify pathogens involved and possible recipient eye infection. METHODS: A hundred sixty-three corneoscleral rim cultures penetrating keratoplasties performed from January 2001 to January 2003 in the Hospital de Clínicas de Porto Alegre were reviewed. Enucleations and corneal storage were done as aseptic as possible and gentamicin 0.3 percent was instilled. Corneoscleral rim was divided into two segments, half was inoculated into Sabouraud broth and the other half into thioglycolate broth; inoculation into blood agar, chocolate agar and MacConkey agar was done later if necessary for pathogen identification. The receiver's eye data were reviewed. RESULTS: There were eleven positive cultures (6.7 percent) out of 163 evaluated corneoscleral rim cultures. Of these, four were Staphylococcus epidermidis, one was Staphylococcus aureus, one was Serratia sp., one was Pseudomonas aeruginosa and the other four were different subtypes of Candida (two Candida sp., one Candida albicans and one Candida parapapilosis). All pathogens were resistant to gentamicin. None of the eleven cases of positive corneoscleral rim cultures resulted in ocular infection at the receiver's eyes (six months follow-up). CONCLUSIONS: We found low rates of positive corneoscleral rim cultures after penetrating keratoplasty at the Porto Alegre Clinical Hospital. The most frequent involved pathogens were Staphylococcus sp and Candida sp. Although we did not identify any postoperative infection at the receiver's eyes, we recommend corneoscleral rim culture for guidance of postoperative infection, a rare but possible devastating ocular event.

Antibiomicrobial susceptibility testing of serratia species isolated from hospitalized patients in two hospitals in Al-Mosul, Iraq

A total of 150 samples [20 blood, 10 throat swabs, 20 sputum, 50 urine and 50 wounds] were collected from patients admitted Al- Salam and Al- Zahrawi hospitals in the city of Mosul, Iraq and examined for the presence of bacteria Serratia species. By using morphological, cultural and biochemical it was possible to identify 25 Serratia isolates among the 150 samples. The identifications was confirmed by the API 20E system. The 25 isolates were identified as Serratia marcescens [12] [both pigmented and non pigmented], S. odoriferal[10], S. odorifera 2[2], and 1 isolate S. plymuthica. Serratia marcescens isolates were highly sensitive to Cephtriaxone and Ciprofloxacin, and 100% resistant to Ampicillin, Nitrofuration, Refampicin and Tetracycline, but expressed variable degree of resistance to other antibiotics. S. odorifera 1 isolates, on the other hand, showed high sensitivity to Cephtriaxone, Chloramphenicol, Ciproflaxocin, Cotrimoxazol and Nalidixic acid, but high resistance to Ampicillin, Cephalexin, and Refampicin, and varied in its response to other antibiotic. S. ordoifera 2 isolates were highly sensitive to Cephalexin, Cephtriaxone, Chloramphenicol, Ciprofloxacin, Cotrimoxazol and Nalidixic acid, but highly resistant to Ampicillin, Refampicin. S. plymuthica isolate was sensitive to Cephtriaxone, Chloramphenicol, Ciprofloxacin, Cotrimoxazol, Gentamycin and Nalidixic acid, but resistant to Ampicillin, Cephlaexin, Refampicin and Tetracycline

Padräo de resistência aos antibióticos entre cepas de Serratia marcescens isoladas de pacientes imunossuprimidos / Resistance standard to antibiotics of strains of Serratia marcescens isolated from immunocompromised patients

Estudamos a epidemiologia e a resistência antimicrobiana de 47 cepas de Serratia isoladas de material clínico em pacientes imunossuprimidos. A maioria das cepas mostrou-se resistente à carbenicilina, ampicilina e cloranfenicol. A cefalotina foi eficaz contra apenas 26 porcento das cepas isoladas. Entre todas, as drogas mais ativas foram amicacina, tobramicina, gentamicina, colistina.