ABSTRACT
Resistance phenotypes characterized by minimum inhibitory concentration, disk diffusion and beta-lactamase production were determined in 434 isolates from patients attending the Sexually Transmitted Disease Service at Dr. José Maria Cullen Hospital in Santa Fe, Argentina. Susceptibility tests to penicillin, tetracycline, ciprofloxacin, espectinomycin, azithromycin and ceftriaxone were performed. Pulsed-field gel electrophoresis was conducted made to on three ciprofloxacin-resistant isolates. Epidemiologically speaking, three interesting events should be highlighted: during 1997, plasmid-mediated high level tetracycline-resistant strains were observed (33.3%); from 2002 to 2004 a significant increase of plasmid-mediated penicillin-resistant strains was registered (9.7% to 34.8%); and in the year 2000 the first two quinolone-resistant strains emerged in the province. In our hospital, the first azithromycin-resistant isolate emerged in 2004. We therefore emphasize the importance of the Clinical Microbiology Laboratory in order to provide information for the empiric treatment of this infection.
Subject(s)
Anti-Bacterial Agents/pharmacology , Neisseria gonorrhoeae/drug effects , Argentina , Drug Resistance, Bacterial , Hospitals , Humans , Microbial Sensitivity Tests , Neisseria gonorrhoeae/isolation & purification , Time FactorsABSTRACT
A case of Streptococcus suis meningitis is described in an immunocompetent patient presenting asthenia, general weakness, fever, vomiting, sensory deterioration and temporospatial disorder. The cerebrospinal fluid and two blood cultures (2/2 bottles) were positive. The isolate was preliminary identified by conventional biochemical tests, and the identification was completed at the Special Bacteriology Service of INEI-ANLIS "Dr. Carlos G. Malbrán". Ampicillin and ceftriaxone treatment was initiated. The isolate was susceptible to ampicillin, cefotaxime and vancomycin. The patient experienced a good outcome but suffered hearing loss. However, after four months he returned with walking ataxia, deafness in his left ear, and hearing loss in the right ear. The patient's retrospective exposure to pigs had been verified. It is important to evaluate predisposing and epidemiologic factors in order to alert about the possible presence of this etiological agent in cases of meningitis or bacteremia.
Subject(s)
Meningitis, Bacterial , Streptococcal Infections , Streptococcus suis , Humans , Immunocompetence , Male , Meningitis, Bacterial/diagnosis , Meningitis, Bacterial/drug therapy , Middle Aged , Streptococcal Infections/diagnosis , Streptococcal Infections/drug therapyABSTRACT
Se describe un caso de meningitis por Streptococcus suis en un paciente inmunocompetente. Presentaba astenia, debilidad generalizada, fiebre (39 °C), vómitos, deterioro del sensorio y desorientación témporo-espacial. Los cultivos de sangre (2/2) y de líquido cefalorraquídeo fueron positivos. La identificación preliminar se realizó utilizando las pruebas bioquímicas convencionales y fue completada en el Servicio Bacteriología Especial del INEI-ANLIS "Dr. Carlos G. Malbrán". Se comenzó el tratamiento con ampicilina y ceftriaxona. El microorganismo aislado demostró sensibilidad a ampicilina, cefotaxima y vancomicina. El paciente evolucionó favorablemente, pero se comprobó leve hipoacusia. Reingresó a los 4 meses con marcha atáxica, anacusia en oído izquierdo e hipoacusia en oído derecho. Continúa con seguimiento neurológico y audiométrico. Retrospectivamente se constató el contacto del paciente con cerdos. Se destaca la importancia de la anamnesis para alertar la sospecha de este agente etiológico en meningitis y bacteriemias.
A case of Streptococcus suis meningitis is described in an immunocompetent patient presenting asthenia, general weakness, fever, vomiting, sensory deterioration and temporospatial disorder. The cerebrospinal fluid and two blood cultures (2/2 bottles) were positive. The isolate was preliminary identified by conventional biochemical tests, and the identification was completed at the Special Bacteriology Service of INEI-ANLIS "Dr. Carlos G. Malbrán". Ampicillin and ceftriaxone treatment was initiated. The isolate was susceptible to ampicillin, cefotaxime and vancomycin. The patient experienced a good outcome but suffered hearing loss. However, after four months he returned with walking ataxia, deafness in his left ear, and hearing loss in the right ear. The patient’s retrospective exposure to pigs had been verified. It is important to evaluate predisposing and epidemiologic factors in order to alert about the possible presence of this etiological agent in cases of meningitis or bacteremia.
Subject(s)
Humans , Male , Middle Aged , Meningitis, Bacterial , Streptococcal Infections , Streptococcus suis , Immunocompetence , Meningitis, Bacterial/diagnosis , Meningitis, Bacterial/drug therapy , Streptococcal Infections/diagnosis , Streptococcal Infections/drug therapySubject(s)
Humans , Male , Middle Aged , Leprosy/complications , Paracoccidioidomycosis/complications , Alcoholism/complications , Antifungal Agents/therapeutic use , Drug Therapy, Combination , Facial Dermatoses/diagnosis , Facial Dermatoses/drug therapy , Immunocompromised Host , Itraconazole/therapeutic use , Leprostatic Agents/therapeutic use , Leprosy/diagnosis , Leprosy/drug therapy , Paracoccidioidomycosis/diagnosis , Paracoccidioidomycosis/drug therapy , Proctitis/diagnosis , Proctitis/drug therapySubject(s)
Leprosy/complications , Paracoccidioidomycosis/complications , Alcoholism/complications , Antifungal Agents/therapeutic use , Drug Therapy, Combination , Facial Dermatoses/diagnosis , Facial Dermatoses/drug therapy , Humans , Immunocompromised Host , Itraconazole/therapeutic use , Leprostatic Agents/therapeutic use , Leprosy/diagnosis , Leprosy/drug therapy , Male , Middle Aged , Paracoccidioidomycosis/diagnosis , Paracoccidioidomycosis/drug therapy , Proctitis/diagnosis , Proctitis/drug therapyABSTRACT
Detection of methicillin-resistant Staphylococcus aureus (MRSA) isolates represents a serious problem to low and media level microbiology labs. In this work cefoxitin (FOX) and cefotaxime (CTX) screen plates (AS) (8-16 microg/ml) with and without 4% of NaCl were evaluated to detect MRSA. Sensitivity, specificity, positive and negative predictive values were determined. The AS oxacillin and the agglutination test MRSA-Screen Latex for the detection of PLP2a were used as reference methods for the evaluation of the different studied screening plates. The 100% (94 strains) PLP2a positive were detected as MRSA with FOX (8 microg/ml), and CTX (8 microg/ml with 4% NaCl) AS. The advantage of FOX AS (8 microg/ml) is that it does not need the addition of NaCl, and CTX AS (8 microg/ml with 4% NaCl) is that cefotaxime is an antimicrobial easily accessible in our country.
Subject(s)
Anti-Bacterial Agents/pharmacology , Cefotaxime/pharmacology , Cefoxitin/pharmacology , Methicillin Resistance , Staphylococcus aureus/drug effects , Humans , Microbial Sensitivity TestsABSTRACT
Superficial mycoses are limited to skin, hair, nails and mucous membranes. The most common etiological agents are dermatophytes and yeasts of Candida genus. The aim of this work was to know the etiological agents of dermatomycoses and their clinical presentation. Were analized 2073 samples of skin, hair, nails, and oral mucous membranes obtained from 1817 patients who attended the Microbiology Branch of the Central Laboratory at Dr. J. M. Cullen Hospital, since September 1999 to September 2003. The samples were examined and identified according to the localization and type of lesion. Out of the total samples 55.67% were positive; 63% were recovered from females, and 37% from males. The most common localization was the skin. Trichophyton rubrum was the most frequent dermatophyte, and among yeasts, Candida albicans was the prevalent species. Fourteen non-dermatophytic fungi (Fusarium spp. and Aspergillus spp.) were isolated, and considered emergent pathogens from superficial mycoses.
