ABSTRACT
The objective of this study was to analyze the incidence of hospital acquired infections (HAIs) in burn patients, and to determine the principle infection sites and the sensitivity profile of the microorganisms to antimicrobials. This is a retrospective cohort study, conducted in a specialized centre for the treatment of burns from January 2009 to December 2013. The sample consisted of 404 patients, divided into two groups: the first group comprised 142 patients without infection, and the second group was made up of 262 patients who had acquired HAIs. There was a predominance of males in both groups. Mean age of the patients without infection was 37 years (SD 14.89), and 38 years (SD 15.78) for the patients with HAIs. Of the 523 infections observed in this study, pneumonia was the most frequent with 216 (41%) cases, followed by urinary tract infections with 137 (26%) episodes. The pathogens identified were Acinetobacter baumannii (93, 40%), Pseudomonas aeruginosa (50, 21%) and Klebsiella (pneumoniae/oxytoca) (23, 10%) and were resistant to most common antimicrobials. In the study population, no pathogens resistant to vancomycin were found. The present study describes high rates of infection in burn victims. Pneumonia was the most frequent site of infection, followed by urinary tract infections caused respectively by non-fermenting bacteria with a high frequency of antimicrobial resistance.
L'objectif de cette étude était d'analyser l'incidence des infections nosocomiales chez les patients brûlés, de déterminer les principaux sites infectés et d'analyser les profils de sensibilité des bactéries. Cette étude rétrospective a été conduite dans un CTB entre janvier 2009 et décembre 2013. L'échantillon de 404 patients a été réparti en 2 groupes: le premier, de 142 patients, sans infection (SI) et le second de 262 patients infectés (I). Les hommes prédominaient dans les 2 groupes. L'âge moyen des patients SI était de 37 +/- 14,89 ans, celui des patients I de 38 +/- 15,78 ans. Les 216 pneumonies représentaient la majorité (41%) des 523 infections relevées, suivies par les infections urinaires (137, 26%). Acinetobacter baumannii (93 isolats; 40%), Pseudomonas æruginosa (50; 21%) et Klebsiella sp. (23; 10%) étaient les plus fréquents et les plus résistants. Nous n'avons pas isolé de bactérie VAN R. On constate une prévalence élevée des infections chez les brûlés, principalement en sites pulmonaire et urinaire, souvent par des BGN non fermentants à résistance élevée.
ABSTRACT
In this study, we report the characterization of a strain of Enterococcus faecium vanA, which grows only in the presence of vancomycin (VDEfm-UEL). The bacterium was isolated from the feces of a female patient who had undergone surgical treatment of Reinke’s edema and was receiving intravenous vancomycin therapy for infection with methicillin/oxacillin-resistant Staphylococcus aureus, a postoperative complication. Antimicrobial dependence was further confirmed by the vancomycin E-test. VDEfm-UEL was also shown to be resistant to ampicillin, ciprofloxacin, chloramphenicol, erythromycin, levofloxacin, penicillin, rifampicin, and teicoplanin. The putative virulence genes efaA, gelE and esp were detected by PCR. The ddl gene from VDEfm-UEL was cloned and sequenced. Vancomycin dependence seems to be associated with the insertion of a nucleotide in that sequence, which results in a frame-shift mutation, introducing a premature stop codon. This is the first report of vancomycin-dependent E. faecium isolation in a university hospital in Brazil.
Subject(s)
Aged , Female , Humans , Anti-Bacterial Agents/pharmacology , Enterococcus faecium/drug effects , Vancomycin Resistance/genetics , Cross Infection/microbiology , Drug Resistance, Multiple, Bacterial/drug effects , Enterococcus faecium/genetics , Enterococcus faecium/isolation & purification , Feces/microbiology , Frameshift Mutation/genetics , Hospitals, University , Microbial Sensitivity Tests , Methicillin-Resistant Staphylococcus aureus/drug effects , Polymerase Chain ReactionABSTRACT
In this study, we report the characterization of a strain of Enterococcus faecium vanA, which grows only in the presence of vancomycin (VDEfm-UEL). The bacterium was isolated from the feces of a female patient who had undergone surgical treatment of Reinke's edema and was receiving intravenous vancomycin therapy for infection with methicillin/oxacillin-resistant Staphylococcus aureus, a postoperative complication. Antimicrobial dependence was further confirmed by the vancomycin E-test. VDEfm-UEL was also shown to be resistant to ampicillin, ciprofloxacin, chloramphenicol, erythromycin, levofloxacin, penicillin, rifampicin, and teicoplanin. The putative virulence genes efaA, gelE and esp were detected by PCR. The ddl gene from VDEfm-UEL was cloned and sequenced. Vancomycin dependence seems to be associated with the insertion of a nucleotide in that sequence, which results in a frame-shift mutation, introducing a premature stop codon. This is the first report of vancomycin-dependent E. faecium isolation in a university hospital in Brazil.
Subject(s)
Anti-Bacterial Agents/pharmacology , Enterococcus faecium/drug effects , Vancomycin Resistance/genetics , Aged , Cross Infection/microbiology , Drug Resistance, Multiple, Bacterial/drug effects , Enterococcus faecium/genetics , Enterococcus faecium/isolation & purification , Feces/microbiology , Female , Frameshift Mutation/genetics , Hospitals, University , Humans , Methicillin-Resistant Staphylococcus aureus/drug effects , Microbial Sensitivity Tests , Polymerase Chain ReactionABSTRACT
The effects of an auxin (NAA) and a cyto kinin (BA), as well as those of peptone, thiamin and coconut water (CW) on callus and protocorm-like body (PLB) induction from root tips of Oncidium varicosum grown in vitro were studied. Relatively high concentrations of NAA favoured callus induction. PLBs were obtained from callus culture either in medium with 15% CW+1.25 mg/1 NAA or in the presence of CW alone. The low regeneration capac ity of buds presented by the calli seems to be the result of an incomplete dedifferentiation of their cells. This seems to keep the callus in a "root state". The apparent presence of high cytokinin levels either in the explant or in the callus may be related to these processes.