Chromosomal and genomic analysis suggests single origin and high molecular differentiation of the B chromosome of Abracris flavolineata.

Supernumerary chromosomes (B chromosomes) have been an intriguing subject of study. Our understanding of the molecular differentiation of B chromosomes from an interpopulation perspective remains limited, with most analyses involving chromosome banding and mapping of a few sequences. To gain insights into the molecular composition, origin, and evolution of B chromosomes, we conducted cytogenetic and next-generation sequencing analysis of the repeatome in the grasshopper Abracris flavolineata across various populations. Our results unveiled the presence of B chromosomes in two newly investigated populations and described new satellite DNA sequences. While we observed some degree of genetic connection among A. flavolineata populations, our comparative analysis of genomes with and without B chromosomes provided evidence of two new B chromosome variants. These variants exhibited distinct compositions of various repeat classes, including transposable elements and satellite DNAs. Based on shared repeats, their chromosomal location, and the C-positive heterochromatin content on the B chromosome, these variants likely share a common origin but have undergone distinct molecular differentiation processes, resulting in varying degrees of heterochromatinization. Our data serves as a detailed example of the dynamic and differentiated nature of B chromosome molecular content at the interpopulation level, even when they share a common origin.

A step forward in the genome characterization of the sugarcane borer, Diatraea saccharalis: karyotype analysis, sex chromosome system and repetitive DNAs through a cytogenomic approach.

Moths of the family Crambidae include a number of pests that cause economic losses to agricultural crops. Despite their economic importance, little is known about their genome architecture and chromosome evolution. Here, we characterized the chromosomes and repetitive DNA of the sugarcane borer Diatraea saccharalis using a combination of low-pass genome sequencing, bioinformatics, and cytogenetic methods, focusing on the sex chromosomes. Diploid chromosome numbers differed between the sexes, i.e., 2n = 33 in females and 2n = 34 in males. This difference was caused by the occurrence of a WZ1Z2 trivalent in female meiosis, indicating a multiple sex-chromosome system WZ1Z2/Z1Z1Z2Z2. A strong interstitial telomeric signal was observed on the W chromosome, indicating a fusion of the ancestral W chromosome with an autosome. Among repetitive DNAs, transposable elements (TEs) accounted for 39.18% (males) to 41.35% (females), while satDNAs accounted for only 0.214% (males) and 0.215% (females) of the genome. FISH mapping revealed different chromosomal organization of satDNAs, such as single localized clusters, spread repeats, and non-clustered repeats. Two TEs mapped by FISH were scattered. Although we found a slight enrichment of some satDNAs in the female genome, they were not differentially enriched on the W chromosome. However, we found enriched FISH signals for TEs on the W chromosome, suggesting their involvement in W chromosome degeneration and differentiation. These data shed light on karyotype and repetitive DNA dynamics due to multiple chromosome fusions in D. saccharalis, contribute to the understanding of genome structure in Lepidoptera and are important for future genomic studies.

[Intra-abdominal infections in adults caused by Streptococcus pneumoniae: report of 18 cases] / Infecciones intraabdominales en adultos causadas por Streptococcus pneumoniae: reporte de 18 casos.

Introduction: Streptococcus pneumoniae (Spn) is occasionally implicated as a cause of intra-abdominal infection (IIASpn) that can be 1) spontaneous bacterial peritonitis (SBP) in elderly patients with previous peritoneal disease, associated with cirrhosis, in most of the cases 2) associated or adjacent to an intra-abdominal organ or postsurgical. (IIAbq) 3) peritonitis in previously healthy young women (PHYW). Our objective is report 18 cases of IIASpn describing: clinical presentation, comorbidities, need for surgery, microbiological findings, sensitivity of Spn to antimicrobials, therapeutic behavior, and evolution. Methods: study of 18 adult patients with IIASpn. Clinical and microbiological characteristics and evolution of infections were analyzed. Results: IIASpn occurred in 9 PHYW, 6 men and 1 woman with SBP, and 2 men with appendicitis. The PHYW were operated on (4 pelviperitonitis, 3 salpingitis, 2 and tubo ovarian abscess) and had a favorable evolution. In the intraoperative samples, pure culture of Spn sensitive to penicillin was isolated. Three of four patients had positive blood culture. Five of seven patients with SBP died and in the peritoneal fluid developed Spn in pure culture. A large percentage of strains presented decreased sensitivity to penicillin. Four of five had a positive blood culture. Patients with appendicitis had favorable evolution. Conclusions: IIASpn in PHYW was the most frequent presentation, surgery played a significant role in treatment and the clinical response was excellent. The second presentation occurred in elderly patients with cirrhosis, most of whom died. Appendicitis was the third presentation in patients who evolved favorably.

Introducción: Streptococcus pneumoniae (Spn) ocasionalmente causa infección intraabdominal (IIASpn) que puede ser: 1) peritonitis bacteriana espontánea (PBE) en paciente añosos con enfermedad peritoneal previa, asociada con cirrosis, en la mayoría de los casos; 2) asociada o adyacente a un órgano intraabdominal o postquirúrgica (IIAbq); 3) peritonitis en mujeres jóvenes previamente sanas (MJPS). Nuestro objetivo es reportar 18 casos de IIASpn describiendo: presentación clínica, comorbilidades, necesidad de cirugía, microbiología y sensibilidad a los antimicrobianos, conducta terapéutica y evolución. Métodos: estudio de 18 pacientes adultos con IIASpn en un período de 23 años. Análisis de las características clínicas, microbiología y evolución de los pacientes. Resultados: las IIASpn ocurrieron en 9 MJPS, 6 varones y una mujer con PBE, y 2 varones con apendicitis. Las MJPS fueron intervenidas quirúrgicamente (4 pelviperitonitis, 3 salpingitis y 2 abscesos tubo ovárico) y evolucionaron favorablemente. En las muestras intraoperatorias se aisló Spn cultivo puro sensible a penicilina. Tres de cuatro pacientes tuvieron hemocultivo positivo. Cinco de siete pacientes con PBE fallecieron y en las muestras de líquido peritoneal desarrolló Spn cultivo puro. Gran porcentaje de cepas presentó sensibilidad disminuida a penicilina. Cuatro de cinco, tuvieron hemocultivo positivo. Los pacientes con apendicitis evolucionaron favorablemente. Conclusiones: La IIASpn en MJPS fue la presentación más frecuente, la cirugía jugó un rol significativo en el tratamiento y la respuesta clínica fue excelente. La segunda presentación ocurrió en pacientes añosos con cirrosis y en su mayoría, fallecieron. La apendicitis fue la tercera presentación en pacientes que evolucionaron favorablemente.

Bacteremia by Aeromonas spp. in adult patients who go to a university hospital. Analysis of ten episodes. / [Bacteriemias por Aeromonas spp. en pacientes adultos que acuden a un hospital universitario. Análisis de diez episodios.]

Introduction: Aeromonas is a common cause of gastroenteritis but occasionally it can cause extraintestinal infections. The incidence of bacteremia by this genus is very low and in general the patients have associated base diseases. Materials and methods: Retrospective analysis of episodes of bacteremia by Aeromonas spp. during a period of eight years in the National Hospital of Clinics of the city of Córdoba, emphasizing age, sex, associated comorbidities, clinical presentation, focus, origin of the infection, clinical evolution, species prevalence and antimicrobial sensitivity of the same . Results: 10 episodes of bacteremia were recorded by Aeromonas spp. 60% corresponded to women and 40% to men. The average age was 65 years. In seven patients the origin of the infection was community and in three nosocomial. 70% of the patients presented predisposing base pathologies. The focus of bacteremia was abdominal in two cases. A. hydrophila complex was responsible for 50% of the cases. 80% of bacteremia were monomicrobial. The isolates generally showed high percentages of sensitivity. Conclusion: Bacteremia occurred in elderly patients of both sexes, most of whom had associated comorbidities. The majority of the infections originated in the community. While bacteremia by Aeromonas spp. it is rare, the mortality found in our study was relatively high despite the high percentage of sensitivity to antimicrobials.

Introducción: Aeromonas es una causa habitual de gastroenteritis pero ocasionalmente puede producir infecciones extraintestinales. La incidencia de bacteriemia por este género es muy baja y en general los pacientes presentan enfermedades de base asociadas. Materiales y métodos: Análisis retrospectivo de los episodios de bacteriemias por Aeromonas spp. durante un período de ocho años en el Hospital Nacional de Clínicas de la ciudad de Córdoba, haciendo hincapié en edad, sexo, comorbilidades asociadas, presentación clínica, foco, origen de la infección, evolución clínica, prevalencia de especies y sensibilidad antimicrobiana de las mismas. Resultados: Se registraron 10 episodios de bacteriemias por Aeromonas spp. El 60% correspondieron a mujeres y el 40% a hombres. La edad promedio fue 65 años. En siete pacientes el origen de la infección fue comunitario y en tres nosocomial. El 70% de los pacientes presentaron patologías de base predisponentes. El foco de la bacteriemia fue abdominal en dos casos. A. complejo hydrophila fue responsable del 50% de los casos. El 80% de las bacteriemias fueron monomicrobianas. Los aislamientos generalmente presentaron altos porcentajes de sensibilidad. Conclusión: Las bacteriemias se presentaron en pacientes de ambos sexos, de edad avanzada, la mayoría de los cuales poseían comorbilidades asociadas. La mayoría de las infecciones tuvieron su origen en la comunidad. Si bien la bacteriemia por Aeromonas spp. es poco frecuente, la mortalidad encontrada en nuestro estudio fue relativamente elevada a pesar del alto porcentaje de sensibilidad a los antimicrobianos.

[Streptococcus agalactiae in non-pregnant adults. Analysis of 10 years in a University Hospital.] / Streptococcus agalactiae en adultos no gestantes. Análisis de 10 años en un Hospital Universitario.

Introduction: Streptococcus agalactiae (GBS) is a recognized pathogen associated with infections in newborns and small infants, pregnant women, and puerperal women. In recent years there has been an increase in infections by this agent in non-pregnant adult patients, being more frequent in people over 65 years of age and with some comorbidity. Methods: retrospective and observational study of samples from non-pregnant adult patients analyzed in the Bacteriology Laboratory of the Hospital Nacional de Clínicas of the city of Córdoba, from January 2008 to December 2017. Age and sex of the patients, comorbidities, and type of sample were analyzed shows. Results: The total of positive samples was 187, 91 (49%) corresponded to women and 96 (51%) to men. The average age was 67 years. Of the samples, urine was the prevalent one with 90 isolates (48.1%), followed by blood with 39 (20.8%) and skin and soft tissues with 38 (20.3%). Of the 187 adults, 177 (95%) had at least one comorbidity, the most frequent being diabetes, followed by neoplasms. Only 10 (5%) did not present comorbidities. Conclusions: The findings in our work, as well as those published by various authors, show the need to consider Streptococcus agalactiae not only a pathogen of neonates and pregnant women, but also of elderly patients with different comorbidities, especially those who suffer from DBT or neoplasia.

Introducción: Streptococcus agalactiae (SGB) es un reconocido patógeno asociado a infecciones en recién nacidos y lactantes pequeños, en mujeres gestantes y en puérperas. En los últimos años se ha observado un incremento de infecciones por este agente en pacientes adultos no gestantes, siendo más frecuentes en mayores de 65 años y con alguna comorbilidad. Métodos: estudio retrospectivo y observacional de muestras de pacientes adultos no gestantes analizadas en el laboratorio de Bacteriología del Hospital Nacional de Clínicas de la ciudad de Córdoba, desde enero de 2008 a diciembre de 2017. Se analizó edad y sexo de los pacientes, comorbilidades y tipo de muestra. Resultados: El total de muestras positivas fue de 187, 91 (49%) correspondieron a mujeres y 96 (51%) a varones. La edad media fue de 67 años. De las muestras, orina fue la prevalente con 90 aislamientos (48.1%), seguidas de sangre con 39 (20.8%) y piel y partes blandas con 38 (20.3%). De los 187 adultos, 177 (95%) presentaron al menos una comorbilidad, siendo la más frecuente diabetes, seguida de neoplasias. Sólo 10 (5%) no presentaron comorbilidades. Conclusión: Los hallazgos en nuestro trabajo, como así también los publicados por diversos autores, ponen en evidencia la necesidad de considerar a Streptococcus agalactiae no sólo un patógeno de neonatos y embarazadas, sino también de pacientes adultos mayores y con diferentes comorbilidades, en especial aquellos que padecen DBT o neoplasias.Palabras claves: Streptococcus agalactiae; infecciones estreptocócicas; inmunosupresión; bacteriemia; comorbilidad.

Detrimental effect of deltamethrin on the central nervous system (synganglion) of Rhipicephalus sanguineus ticks.

Ticks are ectoparasites of medical and veterinary importance, which transmit many infectious agents, causing significant damage to the hosts. The "dog tick" Rhipicephalus sanguineus is responsible for transmitting several pathogens to dogs, motivating researchers to investigate efficient and sustainable control methods. Currently, chemical acaricides currently in use target the central nervous system (synganglion), which is responsible for controlling all the systemic functions of the ticks. Here, the neurotoxic potential of deltamethrin on the synganglion of unfed R. sanguineus female ticks was investigated. The results showed that the synganglion of the females belonging to the control group presented intact morphological characteristics; however, the ones from the treatment group (exposed to 1.5, 3.12 and 6.25 ppm of deltamethrin) displayed alterations, which were increasingly intense as the concentration increased. Observed alterations were mainly in the cortex region and in the neuropile, indicating that the deltamethrin is neurotoxic.

Neumonía por Corynebacterium pseudodiphtheriticum / Pneumonia caused by Corynebacterium pseudodiphtheriticum

Corynebacterium pseudodiphtheriticum forma parte de la microbiota normal de orofaringe y de piel. Sin embargo, en las últimas décadas está emergiendo como oportunista causante de infecciones clínicamente significativas en pacientes con algún compromiso previo. Se refiere el caso clínico de una paciente de 76 años con antecedentes de hipertensión arterial, hipotiroidismo, diabetes tipo 2 e insuficiencia renal crónica, que presentó neumonía durante su estadía en terapia intensiva. El examen directo del esputo inducido (coloración de Gram) reveló una muestra representativa con abundante microbiota monomicrobiana constituida por bacilos gram positivos pleomórficos corineformes y el cultivo presencia de C. pseudodiphtheriticum. La paciente recibió medicación empírica con cefalosporina de tercera generación con evolución favorable.

Microorganisms of the genera Corynebacterium, specie pseudodiphtheriticum are a part of the indigenous microbiota of human skin and oropharinx. Nevertheless in recent decades these bacilli are emerging as opportunistic pathogens causing clinically significant infections in patients with previous compromise. We report the case of a 76 years old female patient, with a history of hypertension, hypothyroidism, type 2 diabetes and chronic renal failure, who presented pneumonia during their stay at the intensive care unit. The induced sputum revealed a representative sample with monomicrobial gram positive pleomorphic coryneform rods (Gram stain) and cultures demonstrated the presence of C. pseudodiphtheriticum as the only bacteria recovered. The pacient received an empirical third generation cephalosporin medication with a succesfull recovery.

Análisis de 117 episodios de bacteriemia por enterococo: estudio de la epidemiología, microbiología y sensibilidad a los antimicrobianos / Analysis of 117 episodes of enterococcal bacteremia: Study of epidemiology, microbiology and antimicrobial susceptibility

La bacteriemia por Enterococcus adquirió un papel relevante en los últimos años, debido al incremento de casos intrahospitalarios. Nuestro objetivo fue describir los episodios ocurridos en pacientes adultos de nuestro hospital. Entre enero del 2000 y diciembre del 2013 se registraron 117 episodios. El 61% eran varones y el 39% mujeres. La edad promedio fue 68 años. El 91% presentaba condiciones predisponentes. El principal foco fue intraabdominal. Enterococcus faecalis fue responsable del 65% de los casos, Enterococcus faecium del 28% y otras especies del 7%. El 34% fueron bacteriemias polimicrobianas. Todas las cepas de E. faecalis fueron sensibles a ampicilina y vancomicina. El 88% de los aislamientos de E. faecium fue resistente a ampicilina y el 54% a vancomicina y teicoplanina. En nuestro hospital, el enterococo es el sexto patógeno causante de bacteriemia intrahospitalaria y predomina E. faecium resistente a ampicilina y vancomicina.

Enterococcal bacteremia has acquired considerable importance in recent years, mainly due to an increased number of cases that occur during hospital admission. We describe the episodes of enterococcal bacteremia in adult patients recorded at our hospital. Between January 2000 and December 2013, 117 episodes were analyzed. Sixty one percent (61%) of the patients were male and 39% female. The mean age was 68. Predisposing factors were present in 91% of patients. The primary source of infection was intraabdominal. Enterococcus faecalis was responsible for 65% of the cases; E. faecium for 28%; and other species for 7%. Thirty four percent (34%) of cases were polymicrobial bacteremia. All E. faecalis isolates were susceptible to ampicillin and vancomycin. Eighty eight percent (88%) of E. faecium were resistant to ampicillin and 54% to vancomycin and teicoplanin. In our hospital, Enterococcus is the sixth pathogen causing nosocomial bacteremia, with high incidence of ampicillin and vancomycin-resistant E. faecium.

[Pneumonia caused byCorynebacterium pseudodiphtheriticum]. / Neumonía por Corynebacterium pseudodiphtheriticum.

Microorganisms of the genera Corynebacterium, specie pseudodiphtheriticum are a part of the indigenous microbiota of human skin and oropharinx. Nevertheless in recent decades these bacilli are emerging as opportunistic pathogens causing clinically significant infections in patients with previous compromise. We report the case of a 76 years old female patient, with a history of hypertension, hypothyroidism, type 2 diabetes and chronic renal failure, who presented pneumonia during their stay at the intensive care unit. The induced sputum revealed a representative sample with monomicrobial gram positive pleomorphic coryneform rods (Gram stain) and cultures demonstrated the presence of C. pseudodiphtheriticum as the only bacteria recovered. The pacient received an empirical third generation cephalosporin medication with a succesfull recovery.

[Analysis of 117 episodes of enterococcal bacteremia: Study of epidemiology, microbiology and antimicrobial susceptibility]. / Análisis de 117 episodios de bacteriemia por enterococo: estudio de la epidemiología, microbiología y sensibilidad a los antimicrobianos.

Enterococcal bacteremia has acquired considerable importance in recent years, mainly due to an increased number of cases that occur during hospital admission. We describe the episodes of enterococcal bacteremia in adult patients recorded at our hospital. Between January 2000 and December 2013, 117 episodes were analyzed. Sixty one percent (61%) of the patients were male and 39% female. The mean age was 68. Predisposing factors were present in 91% of patients. The primary source of infection was intraabdominal. Enterococcus faecalis was responsible for 65% of the cases; E. faecium for 28%; and other species for 7%. Thirty four percent (34%) of cases were polymicrobial bacteremia. All E. faecalis isolates were susceptible to ampicillin and vancomycin. Eighty eight percent (88%) of E. faecium were resistant to ampicillin and 54% to vancomycin and teicoplanin. In our hospital, Enterococcus is the sixth pathogen causing nosocomial bacteremia, with high incidence of ampicillin and vancomycin-resistant E. faecium.

Atrial natriuretic factor: is it responsible for hyponatremia and natriuresis in neurosurgery? / Fator natriurético atrial: ele é o responsável pela hiponatremia e natriurese em neurocirurgia?

OBJECTIVE: To evaluate the presence of hyponatremia and natriuresis and their association with atrial natriuretic factor in neurosurgery patients. METHODS: The study included 30 patients who had been submitted to intracranial tumor resection and cerebral aneurism clipping. Both plasma and urinary sodium and plasma atrial natriuretic factor were measured during the preoperative and postoperative time periods. RESULTS: Hyponatremia was present in 63.33% of the patients, particularly on the first postoperative day. Natriuresis was present in 93.33% of the patients, particularly on the second postoperative day. Plasma atrial natriuretic factor was increased in 92.60% of the patients in at least one of the postoperative days; however, there was no statistically significant association between the atrial natriuretic factor and plasma sodium and between the atrial natriuretic factor and urinary sodium. CONCLUSION: Hyponatremia and natriuresis were present in most patients after neurosurgery; however, the atrial natriuretic factor cannot be considered to be directly responsible for these alterations in neurosurgery patients. Other natriuretic factors are likely to be involved.

Fator natriurético atrial: ele é o responsável pela hiponatremia e natriurese em neurocirurgia? / Atrial natriuretic factor: is it responsible for hyponatremia and natriuresis in neurosurgery?

RESUMO Objetivo: Avaliar a presença de hiponatremia e natriurese, bem como suas associações com o fator natriurético atrial em pacientes de neurocirurgia. Métodos: Foram incluídos 30 pacientes submetidos à ressecção de tumor intracraniano e à clipagem de aneurisma cerebral. Os níveis plasmáticos e urinários de fator natriurético atrial foram medidos durante os períodos pré e pós-operatório. Resultados: Hiponatremia esteve presente em 63,33% dos pacientes, particularmente no primeiro dia pós-operatório. Observou-se natriurese em 93,33% dos pacientes, principalmente no segundo dia pós-operatório. Os níveis plasmáticos de fator natriurético atrial estavam aumentados em 92,60% dos pacientes em pelo menos um dos dias pós-operatórios, mas não houve associação estatisticamente significante entre fator natriurético atrial e sódio plasmático, e entre fator natriurético atrial e sódio urinário. Conclusão: Após neurocirurgia, na maior parte dos pacientes, estiveram presentes hiponatremia e natriurese; contudo, o fator natriurético atrial não pôde ser considerado diretamente responsável por tais alterações nos pacientes neurocirúrgicos. Provavelmente, há o envolvimento de outros fatores natriuréticos.

ABSTRACT Objective: To evaluate the presence of hyponatremia and natriuresis and their association with atrial natriuretic factor in neurosurgery patients. Methods: The study included 30 patients who had been submitted to intracranial tumor resection and cerebral aneurism clipping. Both plasma and urinary sodium and plasma atrial natriuretic factor were measured during the preoperative and postoperative time periods. Results: Hyponatremia was present in 63.33% of the patients, particularly on the first postoperative day. Natriuresis was present in 93.33% of the patients, particularly on the second postoperative day. Plasma atrial natriuretic factor was increased in 92.60% of the patients in at least one of the postoperative days; however, there was no statistically significant association between the atrial natriuretic factor and plasma sodium and between the atrial natriuretic factor and urinary sodium. Conclusion: Hyponatremia and natriuresis were present in most patients after neurosurgery; however, the atrial natriuretic factor cannot be considered to be directly responsible for these alterations in neurosurgery patients. Other natriuretic factors are likely to be involved.

Community-acquired bacteremia in adult patients. analysis of 645 episodes.

Bacteremia is an important cause of morbimortality. This study describes the episodes of communityacquired bacteremia in adult patients registered at our hospital. Between January 2005 and December 2013, 645 episodes were studied. A total of 51% of patients were male and 49% female. The mean age was 67. The most frequent comorbidities were: diabetes (18%), neoplasia (15%), heart disease (10%) and HIV infection (6%). The focus was: urinary (22%), respiratory (18%), cutaneous (15%), abdominal (13%), and others (4%). Gram-negative bacteria prevailed (51.88%). The most frequent microorganisms were Escherichia coli (30.29%), Streptococcus pneumoniae (15.51%), y Staphylococcus aureus (14.06%). Bacteremia was polymicrobial in 7.14% of the cases. Forty percent of E. coli isolates were resistant to ciprofloxacin and 6% to ceftazidime. Fifteen percent of S. aureus strains were resistant to methicillin whereas only 7% of S. pneumoniae expressed high resistance to penicillin with MICs = 2 µg/ mL, according to meningitis breakpoints.

[Community-acquired bacteremia in adult patients attending the emergency service of a teaching hospital]. / Bacteriemias de origen comunitario en pacientes adultos que acuden al servicio de urgencias de un hospital universitario.

Bacteremia is an important cause of morbimortality. This study describes the episodes of community-acquired bacteremia in adult patients registered at our hospital. Between January 2005, and December 2009, 271 episodes were studied. The diagnostic yield of blood cultures was 13.5 %. A total of 52 % of patients were male and 48 % female. The mean age was 60. The most frequent comorbidities were: diabetes (21 %), neoplasia (18 %), cardiopathy (11 %), and HIV infection (8 %). The focus was- respiratory (21 %), urinary (15 %), cutaneous (9 %), and others (13 %). Gram-positive bacteria prevailed (51.4%). The most frequent microorganisms were Escherichia coli (25 %), Streptococcus pneumoniae (22.9 %), and Staphylococcus aureus (12.3 %). Bacteremia was polymicrobial in 7 % of the cases. Thirty three percent of E. coli isolates were resistant to ciprofloxacin and 6 % to ceftazidime. Fourteen percent of S. aureus strains were resistant to oxacillin whereas only 7 % of S. pneumoniae expressed high resistance to penicillin with MICs = 2 ug/ml, according to meningitis breakpoints.

Bacteriemias de origen comunitario en pacientes adultos que acuden al servicio de urgencias de un hospital universitario / Community-acquired bacteremia in adult patients attending the emergency service of a teaching hospital

La bacteriemia es causa importante de morbimortalidad. Nuestro objetivo es describir una serie de episodios de bacteriemia de origen comunitario en adultos, registrados en el hospital de Clínicas de Córdoba. Entre enero de 2005 y diciembre de 2009 se estudiaron 271 episodios. La rentabilidad diagnóstica del hemocultivo fue 13,5 %. El 52 % de los pacientes eran varones y el 48 % mujeres, la edad promedio fue de 60 años. Las comorbilidades prevalentes fueron diabetes (21 %), neoplasia (18 %), cardiopatía (11 %) e infección por HIV (8 %). Los focos que se pudieron establecer fueron el respiratorio (21 %), el urinario (15 %), el cutáneo (9 %) y otros (13 %). Predominaron las bacterias gram positivas (51,4 %). Los microorganismos más frecuentes fueron Escherichia coli (25 %), Streptococcus pneumoniae (22,9 %) y Staphylococcus aureus (12,3 %). La bacteriemia fue polimicrobiana en el 7 % de los casos. El 33 % de los aislamientos de E. coli presentó resistencia a la ciprofloxacina y el 6 % a la ceftacidima. El 14 % de los aislamientos de S. aureus fue resistente a la oxacilina. Solo el 7 % de los aislamientos de S. pneumoniae expresó altos niveles de resistencia a la penicilina según el criterio poblacional, con CIM = 2 ug/ml.

Bacteremia is an important cause of morbimortality. This study describes the episodes of community-acquired bacteremia in adult patients registered at our hospital. Between January 2005, and December 2009, 271 episodes were studied. The diagnostic yield of blood cultures was 13.5 %. A total of 52 % of patients were male and 48 % female. The mean age was 60. The most frequent comorbidities were: diabetes (21 %), neoplasia (18 %), cardiopathy (11 %), and HIV infection (8 %). The focus was- respiratory (21 %), urinary (15 %), cutaneous (9 %), and others (13 %). Gram-positive bacteria prevailed (51.4%). The most frequent microorganisms were Escherichia coli (25 %), Streptococcus pneumoniae (22.9 %), and Staphylococcus aureus (12.3 %). Bacteremia was polymicrobial in 7 % of the cases. Thirty three percent of E. coli isolates were resistant to ciprofloxacin and 6 % to ceftazidime. Fourteen percent of S. aureus strains were resistant to oxacillin whereas only 7 % of S. pneumoniae expressed high resistance to penicillin with MICs = 2 ug/ml, according to meningitis breakpoints.

Bacteriemias de origen comunitario en pacientes adultos que acuden al servicio de urgencias de un hospital universitario / Community-acquired bacteremia in adult patients attending the emergency service of a teaching hospital

La bacteriemia es causa importante de morbimortalidad. Nuestro objetivo es describir una serie de episodios de bacteriemia de origen comunitario en adultos, registrados en el hospital de Clínicas de Córdoba. Entre enero de 2005 y diciembre de 2009 se estudiaron 271 episodios. La rentabilidad diagnóstica del hemocultivo fue 13,5 %. El 52 % de los pacientes eran varones y el 48 % mujeres, la edad promedio fue de 60 años. Las comorbilidades prevalentes fueron diabetes (21 %), neoplasia (18 %), cardiopatía (11 %) e infección por HIV (8 %). Los focos que se pudieron establecer fueron el respiratorio (21 %), el urinario (15 %), el cutáneo (9 %) y otros (13 %). Predominaron las bacterias gram positivas (51,4 %). Los microorganismos más frecuentes fueron Escherichia coli (25 %), Streptococcus pneumoniae (22,9 %) y Staphylococcus aureus (12,3 %). La bacteriemia fue polimicrobiana en el 7 % de los casos. El 33 % de los aislamientos de E. coli presentó resistencia a la ciprofloxacina y el 6 % a la ceftacidima. El 14 % de los aislamientos de S. aureus fue resistente a la oxacilina. Solo el 7 % de los aislamientos de S. pneumoniae expresó altos niveles de resistencia a la penicilina según el criterio poblacional, con CIM = 2 ug/ml.(AU)

Bacteremia is an important cause of morbimortality. This study describes the episodes of community-acquired bacteremia in adult patients registered at our hospital. Between January 2005, and December 2009, 271 episodes were studied. The diagnostic yield of blood cultures was 13.5 %. A total of 52 % of patients were male and 48 % female. The mean age was 60. The most frequent comorbidities were: diabetes (21 %), neoplasia (18 %), cardiopathy (11 %), and HIV infection (8 %). The focus was- respiratory (21 %), urinary (15 %), cutaneous (9 %), and others (13 %). Gram-positive bacteria prevailed (51.4%). The most frequent microorganisms were Escherichia coli (25 %), Streptococcus pneumoniae (22.9 %), and Staphylococcus aureus (12.3 %). Bacteremia was polymicrobial in 7 % of the cases. Thirty three percent of E. coli isolates were resistant to ciprofloxacin and 6 % to ceftazidime. Fourteen percent of S. aureus strains were resistant to oxacillin whereas only 7 % of S. pneumoniae expressed high resistance to penicillin with MICs = 2 ug/ml, according to meningitis breakpoints.(AU)

Bacteriemias de origen comunitario en pacientes adultos que acuden al servicio de urgencias de un hospital universitario / Community-acquired bacteremia in adult patients attending the emergency service of a teaching hospital

La bacteriemia es causa importante de morbimortalidad. Nuestro objetivo es describir una serie de episodios de bacteriemia de origen comunitario en adultos, registrados en el hospital de Clínicas de Córdoba. Entre enero de 2005 y diciembre de 2009 se estudiaron 271 episodios. La rentabilidad diagnóstica del hemocultivo fue 13,5 %. El 52 % de los pacientes eran varones y el 48 % mujeres, la edad promedio fue de 60 años. Las comorbilidades prevalentes fueron diabetes (21 %), neoplasia (18 %), cardiopatía (11 %) e infección por HIV (8 %). Los focos que se pudieron establecer fueron el respiratorio (21 %), el urinario (15 %), el cutáneo (9 %) y otros (13 %). Predominaron las bacterias gram positivas (51,4 %). Los microorganismos más frecuentes fueron Escherichia coli (25 %), Streptococcus pneumoniae (22,9 %) y Staphylococcus aureus (12,3 %). La bacteriemia fue polimicrobiana en el 7 % de los casos. El 33 % de los aislamientos de E. coli presentó resistencia a la ciprofloxacina y el 6 % a la ceftacidima. El 14 % de los aislamientos de S. aureus fue resistente a la oxacilina. Solo el 7 % de los aislamientos de S. pneumoniae expresó altos niveles de resistencia a la penicilina según el criterio poblacional, con CIM = 2 ug/ml.(AU)

Bacteremia is an important cause of morbimortality. This study describes the episodes of community-acquired bacteremia in adult patients registered at our hospital. Between January 2005, and December 2009, 271 episodes were studied. The diagnostic yield of blood cultures was 13.5 %. A total of 52 % of patients were male and 48 % female. The mean age was 60. The most frequent comorbidities were: diabetes (21 %), neoplasia (18 %), cardiopathy (11 %), and HIV infection (8 %). The focus was- respiratory (21 %), urinary (15 %), cutaneous (9 %), and others (13 %). Gram-positive bacteria prevailed (51.4%). The most frequent microorganisms were Escherichia coli (25 %), Streptococcus pneumoniae (22.9 %), and Staphylococcus aureus (12.3 %). Bacteremia was polymicrobial in 7 % of the cases. Thirty three percent of E. coli isolates were resistant to ciprofloxacin and 6 % to ceftazidime. Fourteen percent of S. aureus strains were resistant to oxacillin whereas only 7 % of S. pneumoniae expressed high resistance to penicillin with MICs = 2 ug/ml, according to meningitis breakpoints.(AU)