RESUMEN
This study evaluates the performance of a modified double-disc test (MDDT) for the detection of extended-spectrum beta-lactamases (ESBLs) in clinical isolates of Escherichia coli and Klebsiella pneumoniae. Ninety-six isolates of E. coli and 40 K. pneumoniae are studied for ESBL production by the National Committee for Clinical Laboratory Standards (NCCLS) combination disc tests and MDDT A total of 112 (82%) isolates (80 [83%] E. coli, 32 [80%] K. pneumoniae) were positive for ESBL by MDDT compared to 102 (75%; 72 [75%] E. coli and 30 [75%] K. pneumoniae) by the NCCLS method. In 10 (7.4%) isolates, ESBLs were detected only by MDDT Twenty-four (17.6%) isolates were negative for ESBL by both methods. The protocol described in this study provides a more sensitive approach than does the NCCLS method for ESBL detection in E. coli and K. pneumoniae.
Asunto(s)
Escherichia coli/enzimología , Klebsiella pneumoniae/enzimología , beta-Lactamasas/análisis , Antibacterianos/metabolismo , Cefepima , Cefalosporinas/metabolismo , Ácido Clavulánico/metabolismo , Farmacorresistencia Bacteriana , Sinergismo Farmacológico , Pruebas de Sensibilidad Microbiana/métodosAsunto(s)
Anemia Macrocítica/etiología , Anciano , Anemia Ferropénica/diagnóstico , Anemia Ferropénica/etiología , Anemia Macrocítica/diagnóstico , Diagnóstico Diferencial , Deficiencia de Ácido Fólico/diagnóstico , Deficiencia de Ácido Fólico/etiología , Humanos , Síndromes de Malabsorción/complicaciones , Síndromes de Malabsorción/diagnósticoRESUMEN
Bullous pemphigoid is a rare complication of frusemide therapy. We present two patients in whom the link between frusemide and this condition was not recognised early, and continued frusemide therapy resulted in prolonged leg blistering and ulceration. On withdrawing the drug, all lesions in both patients resolved completely. Although uncommon, this frusemide reaction needs to be borne in mind as it can add to the morbidity of elderly patients with heart failure.
