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1.
J Small Anim Pract ; 59(7): 438-443, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29667183

RESUMO

OBJECTIVE: To study the effect of a 14-day administration of the probiotic Enterococcus faecium SF68 on serum concentrations of cobalamin and folate in healthy dogs. MATERIALS AND METHODS: Thirty-six healthy dogs were randomly allocated between probiotic and control groups. Enterococcus faecium SF68 was administered to the probiotic group for 14 days whereas the control group did not receive any product. A blood sample was taken from all dogs when starting the administration (day 1), when the administration ended (day 14) and 14 days later (day 28). Serum cobalamin and folate concentrations and the canine inflammatory bowel disease activity index scores were determined at each time point. RESULTS: There was a progressive reduction of mean serum cobalamin in the probiotic group during the 28-day study, with significantly lower concentration at day 28 compared to baseline and day 14 concentrations. Moderate hypocobalaminaemia was observed in eight dogs at day 28. Probiotic administration was associated with a non-significant increase in mean serum folate concentration at day 14, and a significant decrease at day 28 compared with day 1. The canine inflammatory bowel disease activity index score remained unaltered during the study. CLINICAL SIGNIFICANCE: Short-term Enterococcus faecium SF68 administration caused a significant reduction of mean cobalamin concentration and moderate hypocobolaminaemia in eight of 18 dogs. Monitoring serum folate appears unnecessary because the probiotic caused a non-significant increase that returned to baseline values after administration was discontinued.


Assuntos
Enterococcus faecium , Ácido Fólico/sangue , Probióticos/administração & dosagem , Vitamina B 12/sangue , Animais , Cães , Feminino , Doenças Inflamatórias Intestinais/diagnóstico , Doenças Inflamatórias Intestinais/veterinária , Masculino , Distribuição Aleatória
2.
Vet Pathol ; 52(2): 377-83, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24788401

RESUMO

Mucoperiosteal exostoses (MpEs) of the tympanic bulla (TB), also referred as middle-ear otoliths, have been occasionally described in dogs and cats in association with clinical signs of otitis media or as an incidental finding, but they have not been recorded in other species. In this report, we describe the radiographic, gross, and histopathologic features of MpEs in 8 African lions (Panthera leo). All animals (5 males and 3 females) were adults that had been kept in captivity and had their skeletons conserved as part of an anatomic academic collection. A radiographic study revealed mineralized structures in the TB consistent with MpEs in 7 of the 16 examined TB; a computed tomography study identified MpEs in 12 of the 16 TB. Six TB from 4 lions were sectioned, and several MpEs were demineralized for histopathologic analysis. Grossly, MpEs appeared variable in number and shape. Some were globular structures that were loosely attached to the mucosal surface of the TB; others were isolated to coalescent bone spicules extending from the mucoperiosteum. Position was also variable, but MpEs frequently developed in the hypotympanum, especially on the ventromedial aspect of the TB wall. Microscopically, MpEs were composed of osteonal bone growing from the periosteum and not by dystrophic calcification of necrotic tissue debris, as is hypothesized in dogs.


Assuntos
Orelha Média/patologia , Exostose/veterinária , Leões , Animais , Exostose/patologia , Feminino , Masculino , Tomografia Computadorizada por Raios X/veterinária
4.
Acta Paediatr ; 97(7): 928-34, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18430068

RESUMO

AIM: Children with leukaemia are at increased risk of pulmonary complications, often with unspecific clinical data, delayed diagnosis and a high mortality rate. We evaluated the usefulness of diagnostic-therapeutic guidelines (DTG) in which specific times for decision making were incorporated. METHODS: Clinical charts of children with acute leukaemia and suspicion of pulmonary involvement were reviewed. Patients were allocated to group I if their diagnostic and therapeutic decisions were in accordance with the DTG, and to group II if not. RESULTS: Children from group I (n=32) and group II (n=28) did not differ with respect to age (9.3+/-0.5 years old, mean+/-SEM), gender, type, risk and stage of leukaemia, anaemia and neutropenia. Total length of hospital stay and hospitalization due to the pulmonary disease were shorter in group I than in group II (14.8+/-2.1 vs. 28.5+/-3.7 days, p=0.0016; and 10.8+/-1.0 vs. 18.4+/-1.8 days, p=0.0003, respectively). Two patients (6.3%) died due to the pulmonary pathology in group I, and nine (32.1%, p=0.016) in group II. CONCLUSIONS: Diagnostic-therapeutic guidelines that incorporate timely decisions constitute a useful algorithm to reduce the length of hospital stay and mortality in children with acute leukaemia and pulmonary infiltrates. A prospective study is needed to validate these results.


Assuntos
Leucemia Mieloide Aguda/complicações , Pneumopatias/diagnóstico , Pneumopatias/terapia , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Adolescente , Algoritmos , Criança , Feminino , Humanos , Pneumopatias/complicações , Masculino
5.
Salud pública Méx ; 47(4): 276-281, jul.-ago. 2005. tab
Artigo em Espanhol | LILACS | ID: lil-417204

RESUMO

OBJETIVO: Determinar frecuencia, serotipos y susceptibilidad a ocho antimicrobianos en Streptococcus pneumoniae aislados de la nasofaringe de una muestra representativa de niños menores de cinco años de edad residentes en el Distrito Federal. MATERIAL Y MÉTODOS: Estudio transversal, hecho de febrero de 2002 a enero de 2003. Se incluyeron niños de 2 meses a 5 años. A los seleccionados se les tomó una muestra de exudado faríngeo con hisopo de alginato de calcio. Bajo técnicas ya establecidas se realizó identificación, tipificación y susceptibilidad a ocho antimicrobianos de los aislamientos de S. pneumoniae. Se utilizó estadística descriptiva, prueba de Ji cuadrada y razón de momios (IC 95 por ciento) para los factores de riesgo. RESULTADOS: Se estudiaron 573 niños. En 122/573 (21.4 por ciento) niños se aisló S. pneumoniae. Los serotipos más frecuentes fueron el 23F, 35, 19F, 11A y 15A; 46 por ciento de los serotipos encontrados no son cubiertos con la vacuna heptavalente. Se encontró 12 por ciento de susceptibilidad reducida a la penicilina, con 3 por ciento de cepas con alta resistencia; la resistencia a eritromicina fue >30 por ciento y para trimetoprim-sulfametoxazol (TMP/SMX) >40 por ciento. No hubo cepas resistentes a vancomicina, cefotaxima, amoxicilina-clavulanato, cloranfenicol o ampicilina. CONCLUSIONES: El porcentaje de serotipos de S. pneumoniae en portadores nasofaríngeos no cubiertos por la vacuna heptavalente es alto, y la resistencia a macrólidos y TMP/SMX es elevada, lo que debe alertar al grupo médico.


Assuntos
Pré-Escolar , Feminino , Humanos , Masculino , Antibacterianos/farmacologia , Nasofaringe/microbiologia , Streptococcus pneumoniae/classificação , Streptococcus pneumoniae/efeitos dos fármacos , Fatores Etários , Estudos Transversais , Farmacorresistência Bacteriana , México , Testes de Sensibilidade Microbiana , Prevalência , Sorotipagem , Streptococcus pneumoniae/isolamento & purificação
6.
Equine Vet J ; 34(2): 171-6, 2002 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11905436

RESUMO

This study was designed to investigate whether horses with clinical signs of back pain due to suspected soft tissue injuries were affected by polysaccharide storage myopathy (PSSM). Diagnosis of PSSM in muscle biopsies obtained from the M. longissimus lumborum of 5 showjumpers and 4 dressage horses with a history of back pain is reported. M. longissimus lumborum biopsies of these horses were characterised histopathologically and in 3/9 cases also by electron microscopy. Observations were compared with M. gluteus biopsies of the same horses, and with M. gluteus biopsies obtained from 6 Standardbreds with recurrent exertional rhabdomyolysis and from 6 healthy trotters. M. longissimus biopsies from horses with back pain showed pathognomonic signs of PSSM, i.e. high glycogen and/or abnormal complex amylase-resistant polysaccharide deposits. Similar features were found in M. gluteus biopsies of the same horses. Sections of horses with rhabdomyolysis had increased PAS stain when compared with healthy horses, but did not show amylase-resistant material. Qualitative observations were corroborated by quantitative histochemistry (optical densities) of sections stained with PAS and amylase PAS. This study demonstrated the presence of PSSM in the M. longissimus of showjumpers and dressage horses with back pain and indicates that epaxial muscle biopsy is an option in diagnosing back problems in horses when clinical examination and imaging techniques do not provide a precise diagnosis.


Assuntos
Dor nas Costas/veterinária , Erros Inatos do Metabolismo dos Carboidratos/veterinária , Doenças dos Cavalos/diagnóstico , Doenças Musculares/veterinária , Polissacarídeos/metabolismo , Amilases/análise , Animais , Dor nas Costas/etiologia , Biópsia , Erros Inatos do Metabolismo dos Carboidratos/diagnóstico , Erros Inatos do Metabolismo dos Carboidratos/patologia , Diagnóstico Diferencial , Glicogênio/análise , Doenças dos Cavalos/patologia , Cavalos , Microscopia Eletrônica , Músculo Esquelético/patologia , Doenças Musculares/diagnóstico , Doenças Musculares/patologia , Rabdomiólise/diagnóstico , Rabdomiólise/patologia , Rabdomiólise/veterinária
8.
Arch Med Res ; 32(3): 238-42, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11395191

RESUMO

BACKGROUND: Pseudomonas aeruginosa is a common cause of nosocomial infections, particularly in intensive care units (ICUs). The aim of this study was to characterize P. aeruginosa clinical isolates by comparing antimicrobial susceptibility patterns with the presence of plasmids and to establish the clonal relatedness by pulsed-field gel electrophoresis (PFGE) typing. METHODS: The patients included those with isolation of P. aeruginosa hospitalized for more than 48 h in the ICU from April to May 1998. Environmental and staff cultures were obtained simultaneously. Minimal inhibitory concentrations, plasmid DNA profiles, and PFGE genomic patterns of enzyme restriction chromosomal DNA were compared. RESULTS: Sixty P. aeruginosa isolates were obtained from 197 clinical specimens, 178 environmental samples, and 47 hand cultures of personnel. Antimicrobial resistance was as follows: tobramycin 100%; ticarcillin, cefotaxime, ceftriaxone, ceftazidime, and gentamicin 80%; cefepime 60%; amikacin, ticarcillin/clavulanate, imipenem, and meropenem 40%; piperacillin and norfloxacin 20%; carbenicillin 12%, and ciprofloxacin 0%. Plasmids were detected in 11 isolates (18%). PFGE typing showed that 23 isolates belonged to a common clone (pattern A), identified from five patients, two nurses, and 10 environmental samples. Ten isolates were grouped in four clusters and 27 isolates had unrelated genomic patterns. There was no relationship among DNA genomic patterns, plasmid profiles, and susceptibility patterns. CONCLUSIONS: PFGE demonstrated the existence of a common clone in a critical care area. Reinforcement of infection control measures is needed to avoid horizontal transmission and severe infections.


Assuntos
Estado Terminal , Infecção Hospitalar/epidemiologia , Reservatórios de Doenças , Infecções por Pseudomonas/epidemiologia , Infecção Hospitalar/complicações , Infecção Hospitalar/microbiologia , DNA Bacteriano , Resistência Microbiana a Medicamentos , Eletroforese em Gel de Campo Pulsado , Humanos , Plasmídeos , Infecções por Pseudomonas/complicações , Infecções por Pseudomonas/microbiologia , Pseudomonas aeruginosa/efeitos dos fármacos , Pseudomonas aeruginosa/genética , Pseudomonas aeruginosa/isolamento & purificação
9.
Gac Med Mex ; 137(2): 105-9, 2001.
Artigo em Espanhol | MEDLINE | ID: mdl-11381796

RESUMO

UNLABELLED: Congenital rubella syndrome (CRS) has been considered an uncommon problem in Mexico. OBJECTIVE: To analyze and describe clinical features of CRS cases in infants from a pediatric hospital in Mexico City during an 8 year period. DESIGN: retrospective study. Patients younger than 18 months of age with a positive serologic test for IgG and IgM rubella antibodies were included. Antibodies were measured by an immunoenzymatic microparticles assay. RESULTS: Fifty-six cases were identified, 42 complete clinical records were available for review. Of these, 23 (54.7%) were female and 19 (45.3%) male. Median for age was five months. A total of 9/42 mothers (21%) had history of rash during pregnancy. IgM antibodies were detected in 15 infants and IgG in 27. Major manifestations were ocular (74%), neurologic (66%), and congenital heart disease (67%). Congenital cataracts were detected in 69%, in 52% hepatomegaly, in 43% jaundice, in 40% anemia, in 48% thrombocytopenia, and hearing loss 19%. CONCLUSION: Five confirmed cases with CRS per year in one hospital indicate a high frequency. Only a small percentage of women had a history of rash during pregnancy. CRS must be investigated in infants with ocular, neurologic, and congenital heart diseases.


Assuntos
Síndrome da Rubéola Congênita/diagnóstico , Feminino , Hospitais Pediátricos , Humanos , Lactente , Masculino , México , Estudos Retrospectivos
10.
Salud Publica Mex ; 43(1): 27-31, 2001.
Artigo em Espanhol | MEDLINE | ID: mdl-11270281

RESUMO

OBJECTIVE: To determine the prevalence of upper respiratory tract colonization by Moraxella catarrhalis in children under six years of age. MATERIAL AND METHODS: A survey was conducted between January and December 1998 in Mexico City, among children aged 2 months to 5 years, selected through cluster sampling. Pharyngeal samples were taken for M. catarrhalis identification. The minimal inhibitory concentration to different antibiotics was obtained and beta-lactamases were determined by the iodometric test. Statistical analysis consisted of frequency distributions, odds ratios, 95% confidence intervals, and Mantel-Haenszel chi 2. Statistical significance was set at p < 0.05. RESULTS: After excluding 37 children, the study population was 604 children from Mexico City; M. catarrhalis was present in 130 pharyngeal specimens (22.9%). Most of the strains were positive for beta-lactamase production (75.4%). Eighty percent of the strains was resistant to penicillin and 70% to ampicillin and amoxicillin. None were resistant to cefotaxime, imipenem, meropenem and erythromycin. CONCLUSIONS: Prevalence of M. catarrhalis upper respiratory tract colonization is similar to that of other respiratory pathogens. These findings warrant future research on the role of M. catarrhalis as an etiologic agent in acute and chronic respiratory infections in Mexico.


Assuntos
Portador Sadio/epidemiologia , Moraxella catarrhalis/isolamento & purificação , Infecções por Neisseriaceae/epidemiologia , Distribuição por Idade , Portador Sadio/microbiologia , Pré-Escolar , Intervalos de Confiança , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , México/epidemiologia , Testes de Sensibilidade Microbiana , Moraxella catarrhalis/efeitos dos fármacos , Infecções por Neisseriaceae/microbiologia , Prevalência , Distribuição por Sexo
11.
Rev Invest Clin ; 52(6): 625-31, 2000.
Artigo em Espanhol | MEDLINE | ID: mdl-11256105

RESUMO

UNLABELLED: Cryptosporidium parvum is associated with diarrheic disease and mainly affects children and immunocompromised hosts. In most of the cases, cryptosporidiosis infection is asymptomatic in immunocompetent subjects. The objectives of the study were to determine the frequency of asymptomatic infection caused by the parasite in children with and without malnutrition and to determine the risk factors associated to infection. METHODS: Children from one to fifteen years old without diarrhea were included, somatometry were performed. The socioeconomic and sanitary conditions were investigated for each family and community. The Faust method and Kinyoun stain were employed identify parasites and Cryptosporidium parvum in feces. Odds ratio (OR), 95% confidence intervals (75% CI), chi 2 Mantel-Haenszel, Fisher exact test and chi 2 trends were calculated. RESULTS: One hundred thirty two children were included. In 10/132 (7.5%) cysts of Cryptosporidium were found, 7/71 in children with malnutrition (9.8%) and 3/61 without malnutrition (4.9%) p = 0.23. 69.7% of the children had parasitosis. According to the presence of C. parvum in feces, the different factors calculated were: Diarrhea in family OR = 5.82 (95%IC 0.86-39.18), not hand washing OR = 5.08 (95%IC 0.62-110.49), age less than 5 years old OR = 4.90 (95%IC 0.60-106.9), drinking non-potable water OR = 3.34 (95%IC 0.40-73.01) and malnutrition 2.11 (95%IC 0.46-10.89). Association was found between the number of people in the same house and the risk of infection (p = 0.005). The presence of diarrhea in the family (OR = 4.15, 95%IC 0.47-36.91) and drinking non-potable water (OR = 4.19, 95%IC 0.48-36.32) were the significant factors in the regression logistic model. CONCLUSIONS: The frequency of Cryptosporidium infection were 7.5%. Diarrhea in the family, overcrowding and drinking non-potable water were associated with C. parvum infection, malnutrition was not a significant risk factor.


Assuntos
Criptosporidiose/complicações , Distúrbios Nutricionais/complicações , Animais , Criança , Pré-Escolar , Criptosporidiose/epidemiologia , Cryptosporidium parvum , Diarreia Infantil/complicações , Feminino , Humanos , Lactente , Masculino , México , População Rural
12.
Salud Publica Mex ; 41 Suppl 1: S12-7, 1999.
Artigo em Espanhol | MEDLINE | ID: mdl-10608172

RESUMO

OBJECTIVE: To describe the results of an epidemiologic surveillance program, from 1990 to the first semester of 1997, in a new high-specialty pediatric hospital and perform a comparison with previous reports. MATERIAL AND METHODS: The total number and type of nosocomial infections, the incidence rate and density incidence for department and division, for different age groups and according to immune statues were registered. RESULTS: The global incidence of nosocomial infections during the period was 25.7 per 100 discharges, with a progressive decrease during the last three years. Although immunocompromised patients had more infections than immunocompetent ones, the difference was not significative. The three most common infections were: pneumonia, vascular line infections and upper respiratory tract infections. It is possible that upper respiratory tract infections are contributing to the elevation of global incidence rates of nosocomial infections. CONCLUSIONS: The change of infection epidemiology regarding previous experience has led to the implementation of programs to prevent the most frequent problems. It is necessary to intensify the different prevention programs and to increase their reach in order to cut down costs in a short term.


Assuntos
Infecção Hospitalar/epidemiologia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Estudos de Coortes , Hospitais com 100 a 299 Leitos , Hospitais Pediátricos , Humanos , Lactente , Recém-Nascido , México/epidemiologia
13.
Am J Vet Res ; 60(11): 1357-9, 1999 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-10566808

RESUMO

OBJECTIVE: To determine whether administration of dexamethasone altered serum trypsin-like immunoreactivity (TLI) in healthy dogs. ANIMALS: 12 healthy dogs. PROCEDURE: Dexamethasone (0.25 mg/kg, p.o., q 24 h) was administered for 7 days. Serum TLI, alpha-amylase and alanine aminotransferase (ALT) activities, and urea and creatinine concentrations were determined on days 0, 7, 14, and 21 of the study. RESULTS: Serum TLI and ALT activities were significantly increased, and serum alpha-amylase activity was significantly decreased after administration of dexamethasone for 7 days. However, values obtained on days 14 and 21 were not significantly different from baseline values. Dexamethasone administration was not associated with any significant changes in serum creatinine or urea concentrations. Serum TLI and alpha-amylase activities were significantly correlated prior to dexamethasone administration. Dogs did not develop clinical signs of pancreatitis. CONCLUSIONS AND CLINICAL RELEVANCE: Dexamethasone administration was associated with an increase in serum TLI. However, values returned to baseline 7 days after dexamethasone administration was discontinued. Serum TLI may be falsely high in dogs that have been treated with dexamethasone in the week preceding analysis.


Assuntos
Dexametasona/farmacologia , Tripsina/sangue , Alanina Transaminase/sangue , Animais , Creatinina/sangue , Cães , Feminino , Testes de Função Renal , Testes de Função Hepática , Masculino , Ovariectomia , Valores de Referência , Ureia/sangue , alfa-Amilases/sangue
14.
Vet Immunol Immunopathol ; 68(2-4): 187-92, 1999 May.
Artigo em Inglês | MEDLINE | ID: mdl-10438319

RESUMO

The effect of different doses of prednisone and dexamethasone on serum C3 levels was determined in 35 dogs. Dogs in Group A (n = 15) were administered prednisone (1.1 mg/kg/day) for 14 days; dogs in Group B (n = 10) were given prednisone at 2.2 mg/kg/day for 7 days; dogs in group C (n = 10) were administered dexamethasone (0.25 g/kg/day) for 7 days. Serum C3 concentrations were determined using a sandwich ELISA in samples obtained before and after glucocorticoid administration. Concentrations were expressed as a percentage of a reference standard. No statistically significant differences were found after glucocorticoid administration in all groups. Thus, short-term administration of prednisone and dexamethasone at commonly used doses did not result in significantly lower serum C3 levels.


Assuntos
Anti-Inflamatórios/administração & dosagem , Complemento C3/metabolismo , Dexametasona/administração & dosagem , Cães/sangue , Prednisona/administração & dosagem , Animais , Ensaio de Imunoadsorção Enzimática/veterinária , Feminino , Masculino
15.
Rev Invest Clin ; 50(1): 13-8, 1998.
Artigo em Espanhol | MEDLINE | ID: mdl-9608784

RESUMO

OBJECTIVE: To analyze an outbreak of Serratia marcescens in a neonatal intensive care unit and identify the risk factors associated to the development of infection. MATERIAL AND METHODS: It was a case-control study from March to July 1995. Factors included were age, sex, intravascular devices, nebulizers, mechanical ventilation, use of total parenteral nutrition (TPN), underlying diseases, surgical interventions, tubes, previous antimicrobial treatment and days of exposure. The associations were explored using the odds ratio. RESULTS: 24 cases and 30 controls were included. In the univariate analysis the significant risk factors (OR,IC) were use of central venous catheter (4.57, 1.01-23.5), days of use of TPN (4.38, 1.03-16.5), days of previous antimicrobial treatment (4.87, 1.60-22) and days of exposure (2.7, 2.65-27.6). In the multivariate analysis the significant risk factors were previous antimicrobial treatment (3.98, 2.36-18.2), days of previous antimicrobial treatment (6.76, 3.02-24.6) and days of use of TPN (4.87, 1.67-15.6). CONCLUSIONS: The significant risk factors in our study were previous antimicrobial treatment, days of antimicrobial and days of use of TPN.


Assuntos
Bacteriemia/epidemiologia , Surtos de Doenças , Unidades de Terapia Intensiva Neonatal , Infecções por Serratia/epidemiologia , Serratia marcescens , Antibacterianos/uso terapêutico , Bacteriemia/microbiologia , Estudos de Casos e Controles , Cateterismo Venoso Central , Feminino , Humanos , Hospedeiro Imunocomprometido , Recém-Nascido , Masculino , México/epidemiologia , Análise Multivariada , Nebulizadores e Vaporizadores , Razão de Chances , Nutrição Parenteral Total , Prevalência , Respiração Artificial , Fatores de Risco
18.
Arch Med Res ; 29(4): 331-5, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9887552

RESUMO

BACKGROUND: The use of combinations of antibiotics has been the cornerstone of therapy for febrile patients with cancer and severe neutropenia. Each empirical regimen should be selected according to the epidemiology and susceptibility patterns in each center. We describe here the experience with empirical antimicrobial treatments in pediatric patients with cancer, fever and severe neutropenia, and identify the risk factors associated with treatment failure. METHODS: This is a prospective study including 145 patients with cancer, and 171 episodes of neutropenia and fever. Blood cultures were taken before initiating empirical treatment: a) carbenicillin (400 mg/kg/day) plus amikacin (21 mg/kg/day) (Cb/ak), and b) ceftazidime (100 mg/kg/day), plus amikacin at the same dosage (Cz/ak). RESULTS: The overall response rate was 54.9% and 56.3% for Cb/ak and Cz/ak, respectively. Fifty-seven episodes (33.3%) were microbiologically documented, gram-positive isolated in 38% and gram-negative in 49%. Risk factors associated significantly with treatment failure were acute myelocytic leukemia (AML) (RR 2.59, CI 95% 1.42-4.7, p = 0.003); bacteriological identification (RR = 4.41, CI 95% 2.21-8.8, p < 0.001), and the presence of two or more sites of infection (RR = 2.89, CI 95% 1.03-8.11, p = 0.03). CONCLUSIONS: The rates of response are similar to the combinations used in the hospital (Cb/ak, Cz/ak). The risk factors associated with treatment failure were AML diagnosis, bacteriological identification, and the presence of two or more sites of infection.


Assuntos
Amicacina/uso terapêutico , Carbenicilina/uso terapêutico , Ceftazidima/uso terapêutico , Febre/tratamento farmacológico , Neutropenia/tratamento farmacológico , Amicacina/administração & dosagem , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Carbenicilina/administração & dosagem , Ceftazidima/administração & dosagem , Criança , Quimioterapia Combinada , Febre/complicações , Humanos , Neutropenia/complicações , Fatores de Risco , Falha de Tratamento
19.
Scand J Infect Dis ; 30(5): 481-3, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-10066049

RESUMO

The aim of this study was to evaluate the utility of a volume-modified blood culture system to diagnose bacteremia in newborns and infants. A total of 793 paired blood cultures, obtained from 464 patients (173 newborns and 291 infants), were analyzed. Vacutainer tubes containing 18 ml supplemented peptone broth sodium-polyanethol-sulfonate were used as the gold standard, in comparison with a blood micro-culture system containing 1.8 ml of the broth. Prior to antibiotic treatment, 2.2 ml of blood was obtained from each patient; 0.2 ml was inoculated in a blood micro-culture tube and 2 ml in a routine tube. Sensitivity, specificity and predictive values were calculated. Microorganisms were isolated in 153 standard blood culture tubes and 151 blood micro-culture tubes. The sensitivity of the blood micro-culture system was 95%, specificity 99% and positive and negative predictive values 96% and 99% respectively. The sensitivity and specificity of blood micro-culture in neonates and infants is high. We recommend that this system be used for the diagnosis of bacteremia in newborns and infants in laboratories where manual systems are still in use.


Assuntos
Bacteriemia/diagnóstico , Técnicas Bacteriológicas , Bacteriemia/sangue , Técnicas de Tipagem Bacteriana , Sangue/microbiologia , Coleta de Amostras Sanguíneas , Meios de Cultura , Humanos , Lactente , Recém-Nascido , Sensibilidade e Especificidade
20.
Arch Med Res ; 28(4): 559-63, 1997.
Artigo em Inglês | MEDLINE | ID: mdl-9428584

RESUMO

Due to the changes in the frequency of penicillin-resistant strains of S. pneumoniae, it is necessary to perform surveillance studies of bacterial resistance. Isolates from the upper respiratory tract of asymptomatic children have been useful. There is no information about the difference between isolates from children with and without upper respiratory tract infection (URTI). The objective of the authors in this paper is to establish the prevalence of carrier-state, serotype and antimicrobial resistance of S. pneumoniae isolates from children with and without acute upper respiratory tract infection (URTI) in a rural area in Mexico. A cross-sectional comparative study was performed in Tlaxcala, Mexico. Children from one month 5 years of age were included. Nasopharyngeal swabs were obtained. Identification was done by international microbiology standards. Serotyping was done by the capsular Quellung test. The susceptibility testing was performed by the agar dilution method. Four-hundred and fifty patients were included. S. pneumoniae was isolated in 134 children (29.7%). Frequency of carriers was greater in patients with URTI (107/323) than without URTI (27/127) (33.1% vs. 21.1% p = 0.012, OR 1.84, IC 95% 1.1-3.08). The six most frequent serotypes were: 6B (16.4%); 19F (11.9%); 19A (6.7%); 14, 23F, and 35 (5.2% each), with no difference among the groups. Only 3% of the strains had high level resistance to penicillin, and 12.6% had intermediate resistance, and for ampicillin 4%, amoxicillin 4%, amoxicillin-clavulanate 4%, ceftriaxone 3%, cefotaxime 1.5%, erythromycin 6%, miocamycin 3%, chloramphenicol 4%, and vancomycin 0%. Trimethoprim-sulfamethoxazole resistance was very high (42%). In conclusion, colonization is higher in children with URTI. Five of the most frequent serotypes identified in this study were the same as those identified in patients with S. pneumoniae invasive diseases in Mexico City. In Tlaxcala, Mexico, beta-lactams could be the drug of choice for the treatment of S. pneumoniae lower respiratory tract infections. It is necessary to perform clinical assays to evaluate the efficacy of trimethoprim-sulfamethoxazole due to the high resistance in vitro.


Assuntos
Antibacterianos/farmacologia , Nasofaringe/microbiologia , Resistência às Penicilinas , Infecções Pneumocócicas/microbiologia , Infecções Respiratórias/microbiologia , População Rural , Streptococcus pneumoniae/efeitos dos fármacos , Combinação Trimetoprima e Sulfametoxazol/farmacologia , Pré-Escolar , Estudos Transversais , Humanos , Lactente , Testes de Sensibilidade Microbiana
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