ABSTRACT
The present study was conducted to estimate the prevalence of metallo-beta-lactamases in 91 consecutive carbapenem resistant Pseudomonas aeruginosa isolates, recovered from inpatients at Hospital de Clínicas in Buenos Aires. Both, phenotypic and genotypic methods detected the presence of carbapenemases in 10 (11%) isolates, corresponding to VIM-11 in 7/10 and VIM-2 in the others. Codifying genes were all included in class 1 integrons, upstream genes coding for aminoglycoside modifying enzymes. One hundred percent sensitivity and specificity was achieved by the metallo-beta-lactamases phenotypic screening method using EDTA (1 micromol) disks in the Pseudomonas aeruginosa isolates included in this study. Sensitivity to aztreonam in carbapenem resistant isolates was suspicious of the presence of these enzymes.
Subject(s)
Carbapenems/pharmacology , Pseudomonas Infections/microbiology , Pseudomonas aeruginosa/enzymology , beta-Lactam Resistance/genetics , beta-Lactamases/analysis , Argentina/epidemiology , Drug Resistance, Multiple, Bacterial , Genotype , Hospitals, University/statistics & numerical data , Humans , Imipenem/pharmacology , Meropenem , Phenotype , Pseudomonas Infections/epidemiology , Pseudomonas aeruginosa/drug effects , Pseudomonas aeruginosa/genetics , Thienamycins/pharmacology , Urban Population , beta-Lactamases/geneticsABSTRACT
Se estudiaron 91 aislamientos de Pseudomonas aeruginosa resistentes a carbapenemes con el objetivo de conocer la prevalencia de metalo-β-lactamasas y evaluar la habilidad del ensayo de inhibición empleando discos de EDTA (1 µmol) en su detección. Se determinó la presencia de carbapenemasas en 10 (11%) de los aislamientos recuperados. La sensibilidad a aztreonam en los aislamientos resistentes a ambos carbapenemes resultó un buen predictor de la presencia de estas enzimas. Dichas carbapenemasas correspondieron a la enzima VIM-2 en tres de ellos y a VIM-11 en otros siete. En todos los casos los genes codificantes de estas enzimas se encontraron localizados en integrones de clase 1 seguidos corriente abajo de genes codificantes de enzimas acetilantes de antibióticos aminoglucosídicos. El ensayo de detección fenotípica de metalo-β-lactamasas empleando discos de EDTA mostró un 100% de especificidad y sensibilidad en la detección de estas enzimas en la población de Pseudomonas aeruginosa analizadas.
The present study was conducted to estimate the prevalence of metallo-β-lactamases in 91 consecutive carbapenem resistant Pseudomonas aeruginosa isolates, recovered from inpatients at Hospital de Clínicas in Buenos Aires. Both, phenotypic and genotypic methods detected the presence of carbapenemases in 10 (11%) isolates, corresponding to VIM-11 in 7/10 and VIM-2 in the others. Codifying genes were all included in class 1 integrons, upstream genes coding for aminoglycoside modifying enzymes. One hundred percent sensitivity and specificity was achieved by the metallo-β-lactamases phenotypic screening method using EDTA (1 µmol) disks in the Pseudomonas aeruginosa isolates included in this study. Sensitivity to aztreonam in carbapenem resistant isolates was suspicious of the presence of these enzymes.
Subject(s)
Humans , Carbapenems/pharmacology , Pseudomonas Infections/microbiology , Pseudomonas aeruginosa/enzymology , beta-Lactam Resistance/genetics , beta-Lactamases/analysis , Argentina/epidemiology , Drug Resistance, Multiple, Bacterial , Genotype , Hospitals, University/statistics & numerical data , Imipenem/pharmacology , Phenotype , Pseudomonas Infections/epidemiology , Pseudomonas aeruginosa/drug effects , Pseudomonas aeruginosa/genetics , Thienamycins/pharmacology , Urban Population , beta-Lactamases/geneticsSubject(s)
Hospitals/history , Poverty/history , Social Welfare/history , France , History, 17th Century , History, 18th CenturyABSTRACT
Four cases of monoclonal gammopathy associated with polyarteritis nodosa are reported. In view of the chronology of events and course of the disease, the connections between protein peak and polyarteritis nodosa can be considered. Management of polyarteritis nodosa is discussed according to the existence of a peak which may originate in myeloma. The part played by plasma exchanges is debated.
Subject(s)
Hypergammaglobulinemia/complications , Polyarteritis Nodosa/etiology , Aged , Antigen-Antibody Complex/immunology , Female , Humans , Hypergammaglobulinemia/immunology , Hypergammaglobulinemia/therapy , Immunoglobulin A/immunology , Immunoglobulin G/immunology , Immunoglobulin Light Chains/immunology , Male , Middle Aged , Plasma Exchange , Polyarteritis Nodosa/immunology , Polyarteritis Nodosa/therapyABSTRACT
The authors describe a case of very severe orthostatic hypotension with an invariable pulse arising during the course of considerable motor diarrhea. The diagnosis of primary dysautonomia was made only after eliminating the many organic causes of diarrhea: microbial, toxic, tumoral endocrine including diabetes. Shy and Drager's syndrome was rejected because of the spontaneously regressive course after a period of 4 years, the patient having had no further signs of orthostatic hypotension.
Subject(s)
Diarrhea/etiology , Dysautonomia, Familial/diagnosis , Hypotension, Orthostatic/etiology , Cholera , Dysautonomia, Familial/complications , Dysautonomia, Familial/metabolism , Humans , Male , Middle Aged , PulseABSTRACT
The authors report four cases of cardiovascular signs in pancreatitis in patients aged between 31 and 42 years. They then consider the main aspects observed. T-wave disorders, pericarditis, myocardial infarction and coronary heart disease and arterio-pancreatic syndrome. They consider the points in common between myocardial infarction and acute pancreatitis and then review the various pathogenic theories proposed.
