RESUMO
The anaerobic bacteria resistance to antibiotics is increasing, and even has appeared against the most active of those, like metronidazol and carbapenems. This fact forces to make and periodical sensibility tests -at least in the most aggressive and virulent species, in cases that they are isolated from life locations and in the absence of therapeutic response- to check the local sensibility and to establish suitable empiric therapies, all based on multicentric studies carried out in order to this or well to check the activity of new antibiotics. For the laboratory routine, the easiest sensibility method is the E-test/MIC evaluator. Another alternative is microdilution, that's only normalized for Bacteroides. There are preliminary facts that allow the use of disc diffusion method in some species of Bacteroides and Clostridium. For the temporal and multicentric studies, the procedure is dilution in agar plate, the reference method.
Assuntos
Bactérias Anaeróbias/efeitos dos fármacos , Humanos , Testes de Sensibilidade Microbiana/métodosRESUMO
La resistencia de las bacterias anaerobias a los antimicrobianos es creciente e incluso ha aparecido frente a los más activos, como metronidazol y carbapenémicos. Este hecho obliga a realizar pruebas de sensibilidad rutinarias -al menos en los casos en que se aíslan de infecciones graves en las especies más agresivas y virulentas y ante la falta de respuesta terapéutica- de forma periódica para comprobar la sensibilidad local y establecer terapias empíricas adecuadas, con independencia de los estudios multicéntricos realizados con estos fines o para comprobar la actividad de nuevos antimicrobianos. Para la rutina de laboratorio, el método de sensibilidad más sencillo es el de difusión a partir de tiras con gradientes exponenciales de antimicrobianos; una alternativa es la microdilución, particularmente a partir de placas comerciales, pero solo está normalizada para Bacteroides. Hay datos preliminares que permiten el uso del método de difusión disco placa en algunas especies de Bacteroides y Clostridium. Para los estudios periódicos y multicéntricos, el procedimiento es la dilución en agar, que es el método de referencia (AU)
The anaerobic bacteria resistance to antibiotics is increasing, and even has appeared against the most active of those, like metronidazol and carbapenems. This fact forces to make and periodical sensibility tests -at least in the most aggressive and virulent species, in cases that they are isolated from life locations and in the absence of therapeutic response- to check the local sensibility and to establish suitable empiric therapies, all based on multicentric studies carried out in order to this or well to check the activity of new antibiotics. For the laboratory routine, the easiest sensibility method is the E-test/MIC evaluator. Another alternative is microdilution, that's only normalized for Bacteroides. There are preliminary facts that allow the use of disc diffusion method in some species of Bacteroides and Clostridium. For the temporal and multicentric studies, the procedure is dilution in agar plate, the reference method (AU)
Assuntos
Humanos , Testes de Sensibilidade Microbiana/métodos , Bactérias Anaeróbias/patogenicidade , Infecções Bacterianas/microbiologia , Resistência Microbiana a Medicamentos , Contagem de Colônia Microbiana/métodosRESUMO
La resistencia de las bacterias anaerobias a los antimicrobianos es creciente e incluso ha aparecido frente a los más activos, como metronidazol y carbapenémicos. Este hecho obliga a realizar pruebas de sensibilidad rutinarias -al menos en los casos en que se aíslan de infecciones graves en las especies más agresivas y virulentas y ante la falta de respuesta terapéutica- de forma periódica para comprobar la sensibilidad local y establecer terapias empíricas adecuadas, con independencia de los estudios multicéntricos realizados con estos fines o para comprobar la actividad de nuevos antimicrobianos. Para la rutina de laboratorio, el método de sensibilidad más sencillo es el de difusión a partir de tiras con gradientes exponenciales de antimicrobianos; una alternativa es la microdilución, particularmente a partir de placas comerciales, pero solo está normalizada para Bacteroides. Hay datos preliminares que permiten el uso del método de difusión disco placa en algunas especies de Bacteroides y Clostridium. Para los estudios periódicos y multicéntricos, el procedimiento es la dilución en agar, que es el método de referencia
The anaerobic bacteria resistance to antibiotics is increasing, and even has appeared against the most active of those, like metronidazol and carbapenems. This fact forces to make and periodical sensibility tests -at least in the most aggressive and virulent species, in cases that they are isolated from life locations and in the absence of therapeutic response- to check the local sensibility and to establish suitable empiric therapies, all based on multicentric studies carried out in order to this or well to check the activity of new antibiotics. For the laboratory routine, the easiest sensibility method is the E-test/MIC evaluator. Another alternative is microdilution, that's only normalized for Bacteroides. There are preliminary facts that allow the use of disc diffusion method in some species of Bacteroides and Clostridium. For the temporal and multicentric studies, the procedure is dilution in agar plate, the reference method
Assuntos
Humanos , Bactérias Anaeróbias , Testes de Sensibilidade Microbiana/métodos , Contagem de Colônia Microbiana , BactériasRESUMO
The aim of this study was to design an aggressive nonlethal animal model that would simulate surgical treatment of the abdominal aorta with a view to studying the systemic inflammatory response. Fourteen pigs were subjected to two sequential experiments. Experiment A was performed to determine the response to two degrees of hemorrhage: (A1) 40% bleeding; and (A2) 60% bleeding over 15 minutes followed by midline laparotomy and aortic dissection. Experiment B included two methods of aortic repair: (B1) aortic resection and replacement with a prosthesis; and (B2) aortic bypass without aortic resection. In the latter two groups, suprarenal aortic cross-clamping was placed for 30 minutes after a 40% hemorrhage. We analyzed various inflammatory markers and mortality. The 40% bleeding (vs. 60%) elicited a smaller decrease in mean arterial pressure (110 +/- 6 vs. 89 +/- 9 mmHg) but did not cause irreversible shock or mortality. After the 40% hemorrhage, the B1 aortic repair caused two cases of paraplegia. We have developed a model to study the combined effect of bleeding and aortic cross-clamping.