RESUMO
Thirty-one strains of Klebsiella pneumoniae (including 10 duplicates) from 21 septicemic pediatric patients (age, <2 months) were studied during a 4-month period (June to October 1996) in which the fatality rate was 62% (13 of 21). These isolates identified by the API 20E system yielded the same biotype. Pulsed-field gel electrophoresis experiments revealed the same clone in 31 strains. The isolates were multidrug-resistant but were still susceptible to ciprofloxacin, imipenem, and cefoxitin. A 135-kb plasmid was harbored in all of the isolates. No transconjugants were obtained that were resistant to ampicillin, cefotaxime, tetracycline, or gentamicin. Isoelectric focusing for beta-lactamases was performed on all strains, and three bands with pIs of 5.4, 7.6, and 8.2 were obtained. Of these, the pI 8.2 beta-lactamase had an extended-spectrum beta-lactamase phenotype. PCR amplification of both TEM- and SHV-type genes was obtained. The sequence analysis of the SHV PCR product indicated a mutation corresponding to the SHV-5 beta-lactamase.
Assuntos
Surtos de Doenças , Hospitais , Infecções por Klebsiella/epidemiologia , Klebsiella pneumoniae/classificação , Klebsiella pneumoniae/enzimologia , beta-Lactamases/metabolismo , Bacteriemia/epidemiologia , Bacteriemia/microbiologia , Técnicas de Tipagem Bacteriana , Infecção Hospitalar , Farmacorresistência Bacteriana , Humanos , Lactente , Recém-Nascido , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/genética , Klebsiella pneumoniae/isolamento & purificação , México/epidemiologia , Testes de Sensibilidade Microbiana , beta-Lactamases/genética , beta-Lactamas/farmacologiaRESUMO
Objetivo: Comunicar la experiencia obtenida al tratar úlceras venosas con apósitos de hidrogel de polimanosa comparándola con un grupo control. Antecedentes: La frecuencia de presentación de úlceras venosas es muy alta y requieren tratamiento local efectivo para lograr su cicatrización. Un producto natural derivado del ALOE-VERA cuyo principio activo es la polimanosa, parece que favorece y acelera la cicatrización. Material y métodos: Se estudiaron 40 pacientes divididos en 2 grupos, 20 tratados con apósitos de hidrogel de polimanosa y 20 tratados sólo con solución físiológica y jabón a los cuales se les hizo seguimiento por 16 semanas y se valoró la velocidad de cicatrización. Resultados: El grupo tratado con polimanosa cicatrizó en un 50 por ciento más rápido que el tratado con agua y jabón. Conclusión: El hidrogel de polimanosa aumenta el doble la velocidad de cicatrización de las úlceras venosas comparado con la curación con solución fisiológica y jabón.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Hidrogel de Polietilenoglicol-Dimetacrilato/uso terapêutico , Curativos Oclusivos , Úlcera Varicosa/terapia , Bandagens , Aloe/uso terapêuticoRESUMO
Resistance to extended-spectrum cephalosporins within members of the family Enterobacteriaceae occurs virtually world-wide. Nevertheless, nothing was known about this problem among isolates from Mexico. To address this issue, we studied oximino-cephalosporin resistant isolates of Klebsiella pneumoniae (13), Escherichia coli (7), and Enterobacter cloacae (23) recovered from patients in Mexico City hospitals during 1990 to 1992. In the presence of clavulanic acid, these strains increased susceptibility to cefotaxime and ceftazidime (MIC90 64 and >256 microg/ml, respectively). The ability of these isolates to transfer resistance to both antibiotics by conjugation was most successfully demonstrated by K. pneumoniae. In all the clinical isolates tested, the largest plasmid coded for the extended-spectrum beta-lactamases (ESBL). Characteristics of pI, by isoelectric focusing (IEF)/bioassay and DNA hybridization with specific probes of TEM and SHV, indicated that in most of the clinical isolates and all transconjugates, the most frequent beta-lactamase coded were SHV-derived (20 strains as 41% of isolates) and a plasmid-encoded beta-lactamase (12 strains as 25% of isolates) (with a pI of >8.2), which is not related to TEM/SHV. Apparently, isolates from Mexico show characteristics similar to isolates from other geographic areas. The type of beta-lactamases coded in these resistant isolates is documented for the first time in Mexico.
Assuntos
Cefalosporinas/farmacologia , Resistência Microbiana a Medicamentos/genética , Enterobacteriaceae/efeitos dos fármacos , Enterobacteriaceae/enzimologia , beta-Lactamases/metabolismo , Conjugação Genética , Enterobacteriaceae/genética , Humanos , México , Testes de Sensibilidade Microbiana , Plasmídeos , beta-Lactamases/genéticaRESUMO
Bacterial resistance to antimicrobial agents is a common problem observed in hospitals. We characterized a clinical isolate of Klebsiella pneumoniae (R-3455) which was resistant to high concentrations of broad spectrum beta-lactams, aminoglycosides, fluoroquinolones, chloramphenicol and tetracycline. Conjugation experiments showed that the multiresistance could be transferred to Escherichia coli J53-2 receptor strain. The transconjugant X-3455 was resistant to all antibacterials assayed in R-3455, except to fluoroquinolones. We found that both strains R-3455 and X-3455 produced a beta-lactamase which was sensitive to clavulanic acid. Southern hybridization and PCR analysis showed the presence of at least, a TEM type beta-lactamase gene in both strains.
