Enterobacterales productores de carbapenemasas en sifones de lavamanos de una Unidad de Paciente Crítico / Carbapenemase-producing Enterobacterales in the sink traps of a Critical Patient Unit

INTRODUCCIÓN: Enterobacterales productores de carbapenemasas (EPC) son una importante causa de infecciones asociadas a la atención en salud (IAAS). El principal reservorio de EPC lo constituyen pacientes infectados y colonizados, sin embargo, también se han identificado reservorios ambientales. OBJETIVO: Detectar la presencia de EPC en los sifones de lavamanos de la unidad de cuidados críticos de pacientes quemados adultos (UPC QMD) y unidad de cuidados críticos de pacientes pediátricos crónicos (UCEP). MÉTODO: Se recolectaron cuatro muestras de sifones de los lavamanos ubicados en el interior de las unidades de pacientes en UCEP y 10 de UPC QMD. A las muestras se les realizó estudio fenotípico y molecular para detección de carbapenemasas en el Instituto de Salud Pública de Chile. RESULTADOS: En los sifones estudiados de UCEP no se aislaron cepas de EPC. En UPC QMD, 50% de los sifones estudiados se aislaron cepas de EPC. CONCLUSIONES: En UPC QMD se objetivó la presencia de EPC en una alta proporción de los sifones de lavamanos testeados, lo que demuestra un reservorio ambiental de bacterias multi-resistentes.

INTRODUCTION: Carbapenemase-producing Enterobacterales (CPE) are an important cause of health care associated infections (HAI). The main reservoir is constituted by infected and colonized patients; however, environmental reservoirs have also been identified. OBJECTIVE: To detect the presence of CPE in the sink traps of the critical care unit for adult burn patients (UPC QMD) and the critical care unit for chronic pediatric patients (UCEP). MATERIAL AND METHOD: Four samples of trap were collected from the sinks located inside the patient units at PICU and 10 at UPC QMD. The samples underwent a phenotypic and molecular study for the detection of carbapenemases at the Institute of Public Health of Chile. RESULTS: In the UCEP no EPC strains were isolated. In UPC QMD, CPE was detected in 50% of the traps. CONCLUSIONS: In UPC QMD, the presence of CPE was observed in a high proportion of the tested sinks traps, which shows an environmental reservoir of multi-resistant bacteria.

[Molecular epidemiology of a streptococcus pyogenes related nosocomial outbreak in a burn unit]. / Epidemiología molecular de un brote de infecciones por streptococcus pyogenes en una unidad de quemados.

BACKGROUND: Group A Streptococcal (GAS) infections have increased in frequency and severity worldwide. During April 1996, a nosocomial outbreak associated to GAS infections affected seven patients admitted to a pediatric burn unit. The causative organism was likely disseminated from the source patient to another child in the emergency room before he was transferred to the burn unit. Patients developed burn infections or invasive disease. One of them died due to a toxic shock syndrome and 3 other lost their skin grafts. Perineal and nasal microbiological surveillance of 42 related health care workers identified only one of them as carrier of S pyogenes. AIM: To report a molecular analysis of an apparently clonal outbreak. MATERIAL AND METHODS: The available isolates were analyzed by molecular methods including random amplified polymorphic DNA analysis (RAPD) with 4 different primers, Sma-I pulsed field gel electrophoresis (PFGE) analysis, and speA, speB and speC detection by polymerase chain reaction (PCR). RESULTS: Two phylogenetically distant and sequentially isolated bacterial groups were identified either by RAPD analysis with selected primers or by Smal-PFGE analysis. The first group involved isolates identified in two patients that included the lethal case. The second bacterial group comprised 5 clinical isolates and the perineal and nasal isolates obtained from a health care worker. Only strains belonging to the first group harbored the speA gene and were associated with invasive disease. The second group could be split further in two subgroups according to their speB profile. CONCLUSIONS: RAPD analysis with selected primers can reproduce the PFGE-discriminating ability on the epidemiological analysis of GAS infections.

Aborto de 2º trimestre y campylobacter jejuni / Abort of second trimester and campylobacter jejuni

Campylobacter jejuni es agente frecuente de infecciones entéricas en todo el mundo. Ocasionalmente puede producir aborto en la mujer. Tiene un mecanismo de transmisión fecal-oral. Posee características de cultivo exigentes y requiere para su aislamiento incubación prolongada. La infección por este microorganismo en Chile es infrecuente y no representa un problema de Salud Pública, no obstante se comunica este caso clínico por las consecuencias que tiene en la gestación. Además se recuerdan las medidas a tomar frente a cuadro febril que aparece durante el embarazo