RESUMO
BACKGROUND: There is an ongoing debate regarding possible cost and benefits, but also harm of universal screening for the emerging sexually transmitted pathogen Mycoplasma genitalium. METHODS: From the initial pool of 8665 samples that were tested, a subset of Chlamydia trachomatis-positive and randomly selected C. trachomatis-negative cervical swabs were further interrogated for M. genitalium by real-time polymerase chain reaction, using a 224 bp long fragment of the glyceraldehyde-3-phosphate dehydrogenase gene. RESULTS: M. genitalium was detected in 4.8% of C. trachomatis-positive samples and none of C. trachomatis-negative samples. Accordingly, a significant association was shown between M. genitalium and C. trachomatis (P < 0.01), but also between M. genitalium and Mycoplasma hominis infection (P < 0.01). CONCLUSIONS: Based on the results, routine screening is recommended only for women with one or more identified risk factors. Moreover, younger age does not represent an appropriate inclusion/exclusion criterion for M. genitalium testing in the low-risk female population.
RESUMO
During the two years period the prevalence of uropathogens responsible for catheter-associated urinary tract infection (CAUTI) in outpatients was investigated including their differences in antimicrobial susceptibility according to the age and gender. Indwelling urinary catheter (IUC) constitutes 0.3% of all processed urine samples. Significant bacteriuria was found in 92.5% of IUC, and polimicrobial ethiology in 63.2%. The most CAUTI (79.3%) was found in elderly male patients (> 65 years). The most frequently isolated uropathogens were Esherichia coli and other Enterobacteriaceae, Pseudomonas aeruginosa, and enterococci. The very high resistance of all Enterobacteriaceae to beta-lactams, fluoroquinolones, and co-trimoxazole was observed with significantly much higher fluoroquinolone (p < 0.01) and co-trimoxazole (p < 0.05) resistance in elderly male patients as compared with younger ones.
Assuntos
Infecções Relacionadas a Cateter/microbiologia , Enterobacteriaceae/isolamento & purificação , Cateterismo Urinário/efeitos adversos , Infecções Urinárias/microbiologia , Idoso , Cateteres de Demora/efeitos adversos , Farmacorresistência Bacteriana Múltipla , Enterobacteriaceae/efeitos dos fármacos , Humanos , Masculino , Pacientes Ambulatoriais , Infecções Urinárias/etiologiaRESUMO
The aim of this investigation was to characterize metallo-beta-lactamases (MBLs) in Pseudomonas aeruginosa isolates from Zagreb, Croatia. One hundred P. aeruginosa isolates with reduced susceptibility to either imipenem or meropenem were tested for the production of MBLs by MBL-Etest. The susceptibility to a wide range of antibiotics was determined by broth microdilution method. The presence of bla(MBL) genes was detected by polymerase chain reaction (PCR). Hydrolysis of 0.1 mM imipenem by crude enzyme preparations of beta-lactamases was monitored by UV spectrophotometer. Outer membrane proteins were prepared and analysed by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE). Six out of 100 isolates were positive for MBLs by Etest. All strains were resistant to gentamicin, ceftazidime and cefotaxime, and all except 1 were resistant to imipenem. Six strains positive for MBLs by Etest were identified as VIM MBL-producers by PCR. Sequencing of bla(VIM) genes revealed the production of VIM-2 beta-lactamase in all 6 strains. This investigation proved the occurrence of VIM-2 beta-lactamase among P. aeruginosa strains from Zagreb, Croatia. VIM-2 beta-lactamase with similar properties has previously been described in another region of Croatia and in Italy, France, Spain, Greece, Taiwan and South Korea, suggesting that this type of enzyme is widespread in the Mediterranean region of Europe and in the Far East.