RESUMEN
Aortic aneurysm infected with Campylobacter fetus spp fetus is rare, the first case having been reported in 1971. We present a case of abdominal aortic aneurysm, with a history of abdominal pain, fever and chills, with identification of this gram negative bacillus in the culture of the aortic wall and visualization of the microorganism in histological examination. Surgical correction was performed by interposition of a dracon prosthetic graft. The patient had a good postoperative course, receiving prolonged antibiotic therapy (intravenous cephalothin for 7 days and oral erythromycin for 6 months), remaining without symptoms for 12 months, when the follow-up was ended. In the 11 cases reported in the literature, 9 presented fever, suggesting the infectious etiology. Four were operated on with the aneurysm already ruptured and all of them died. The other patients, with non-ruptured aneurysms at the time of the operation, were all symptomatic, and they survived. Anatomic reconstruction was performed in 4 cases, with dacron graft interposition and antibioticotherapy, without reported signs of infection on the follow-up (6 to 45 months). Aortic infection with Campylobacter fetus spp fetus is potentially fatal, needing immediate surgical treatment. It is possible to have good long term results with an anatomically placed prosthetic graft and antibiotic therapy.
Asunto(s)
Aneurisma de la Aorta Abdominal/microbiología , Infecciones por Campylobacter/complicaciones , Campylobacter fetus , Anciano , Aneurisma de la Aorta Abdominal/cirugía , Humanos , MasculinoRESUMEN
Membros do gênero staphylococcus säo os patógenos mais comuns encontrados no ambiente hospitalar e vêm adquirindo resistência múltipla aos antimicrobianos. OBJETIVO. Avaliar as atividades inibitórias in vitro da teicoplanina e da vancomicina frente a 195 amostras de estafilococos isolados de processos infecciosos significativos, provenientes de pacientes internados. MÉTODOS. foram estudadas 100 amostras de Staphylococcus aureus, sendo a metade representada por cepas resistentes à oxacilina, e 95 amostras de estafilococos coagulase negativos (ECN), sendo 44 cepas resistentes à oxacilina, que foram submetidas às provas de sensibilidade pela técnica da diluiçäo en ágar e da difusäo do disco em ágar. RESULTADOS. Todas as cepas (100 por cento) foram sensíveis à vancomicina; as amostras de S. aureus apresentaram MIC90 DE 0,5µg/mL, enquanto que os ECN mostraram MIC90 de 1,0µg/mL. Para a teicoplanina, 98,5 por cento das amsotras se mostraram sensíveis; o MIC90 foi de 0,5µg/mL para as cepas de S. aureus, de 2,0 µg/mL para as cepas de ECN (sensíveis à oxacilina) e de 8,0µg/mL para as cepas de ECN (resistentes à oxacilina). CONCLUSÄO. Do ponto de vista microbiológico, os resultados demonstraram o alto potencial de ambas as drogas como agentes terapêuticos para infecçöes causadas por estafilococos multiresistentes de origem hospitalar
Asunto(s)
Staphylococcus aureus/efectos de los fármacos , Vancomicina/farmacología , Teicoplanina/farmacología , Coagulasa , Pruebas de Sensibilidad Microbiana , Farmacorresistencia MicrobianaRESUMEN
Members of the genera Staphylococcus are the most common pathogens found in the hospital environment and they are acquiring resistance to multiple drugs. PURPOSE--To evaluate the in vitro activity of teicoplanin and vancomycin against 195 strains of staphylococci isolated from in-patients. METHODS--One hundred strains of Staphylococcus aureus (50% methicillin-resistant) and 95 strains of coagulase-negative staphylococci (46.3% strains methicillin-resistant) were tested by the agar dilution and the disk diffusion techniques. RESULTS--All strains (100%) were susceptible to vancomycin, S. aureus strains presented MIC90 of 0.5 microgram/mL whereas strains of coagulase-negative staphylococci showed MIC90 of 1.0 microgram/mL. For teicoplanin, 98.5% of the strains were susceptible. MIC90 values were 0.5 microgram/mL for S. aureus strains, 2.0 micrograms/mL for coagulase-negative methicillin-susceptible staphylococci strains and 8.0 micrograms/mL for coagulase-negative methicillin-resistant staphylococci strains. CONCLUSION--From the microbiological point of view, the results showed a high potential for both drugs as therapeutic agents in staphylococcal infections due to multiresistant strains of hospital origin.