Bacterial and fungal organisms in otitis externa patients without fungal infection risk factors in Erzurum, Turkey / Organismos bacterianos e fúngicos em pacientes com otite externa sem fatores de risco para infecção fúngica em Erzurum, Turquia

AIM: To describe the bacterial and fungal organisms in otitis externa patients without other risk factors for fungal infections. STUDY DESIGN: Cross sectional cohort descriptive study. MATERIALS AND METHODS: Ear swabs were obtained from 362 patients aged 1 to 55 years old with clinically diagnosed otitis externa in Erzurum, Turkey, between January 2006 and April 2007, and cultured for aerobic and anaerobic bacteria and fungi, using EMB, 5 percent sheep's blood, chocolate agar, anaerobic blood agar plate, thioglycollate broth and sabaroud agar using standard microbiological technique to diagnose isolates. RESULTS: 219 cultures were positive and a total of 267 isolates were obtained. Of the isolates, 68.16 percent (n: 182) were aerobic or facultative bacteria, 1.12 percent (3) were anaerobic bacteria, 30.71 percent (82) were fungi and 17.5 percent (38) were polymicrobial infections. CONCLUSION: Fungal organisms especially Candida species may be isolated from ears of otitis externa patients without fungal infection risk factors such as ear self-cleaning, local antimicrobial, antifungal or corticosteroid drops or systemic antimicrobial or antifungal agents within the preceding week. Bacterial and fungal cultures may be recommended, and anti-fungal agents may be added, to treatment regimens in patients with otitis externa.

OBJETIVO: Descrever fungos e bactérias presentes em pacientes com otite externa sem fator de risco para infecções fúngicas. FORMA DE ESTUDO: Estudo descritivo de coorte transversal. MATERIAIS E MÉTODOS: Amostras por raspagem de cotonetes (swabs) no ouvido foram obtidas de 362 pacientes com idades entre 1 e 55 anos, com diagnóstico clínico de otite externa em Erzurum, Turquia, entre janeiro de 2006 e abril de 2007. Essas amostras foram cultivadas em meio de cultura, 5 por cento de sangue de ovelha, ágar chocolate, ágar sangue anaeróbio, banho em tioglicolato e ágar Saboroud, usando técnicas padrão de microbiologia para identificar os isolados. RESULTADOS: Obtivemos 219 culturas positivas e 267 isolados. Dos isolados, 68,16 por cento (n: 182) eram bactérias aeróbias ou facultativas, 1,12 por cento (3) eram bactérias anaeróbias, 30,71 por cento (82) eram fungos e 17.5 por cento (38) eram germes polimicrobianos. CONCLUSÃO: Fungos, especialmente espécies de Candida podem ser encontradas em ouvidos de pacientes com otite externa sem fatores de risco para infecção fúngica tais como autolimpeza do ouvido, uso de antimicrobiano local, corticosteroides ou antifúngicos tópicos ou agentes antibacterianos e antifúngicos sistêmicos na semana anterior. Culturas de bactérias e fungos podem ser recomendadas, e agentes antifúngicos podem ser acrescentados a esquemas de tratamento de pacientes com otite externa.

Artritis séptica y osteomielitis aguda en pediatría / Septic artritis and acute osteomielitis in pediatrics

Objective: To review the clinical presentation, the organisms responsible for arthritis and acute osteomyelitis and the intrahospitalary and ambulatorie management in childhood less than 16 years in the post Haemophilus influenza tipe B vaccine era. Methods: Retrospective review of clinic case account in the Hospital Clínico de la Pontificia Universidad Católica in the period from January 2004 to July 2008 with the diagnosis of acute infection oteomyelitis and septic arthritis. There were include all the cases, with or without surgical management and intra and extra hospitalary infection source. Results: There were 32 total cases, 22 acute osteomyelitis (AOM) and 16 septic arthritis (SA). Pain and functional impotence of lower limbs, were the 2 first sintoms. The agent was isolated in 25 percent of the SA and 54.5 percent of the AOM. The most frecuent isolated agent in AOM was the Staphilococcus aureus. In SA, there was no isolated this agent. Discussion: The clinical findings of the osteoarticular infections (OAI), presents with a loss florid illness than the classical presentation. To know the agent take time. For that reason, we thought that the empirical intravenosus antibiotical treatment is fundamental in this knew studies about this matter, that can propuose an universal empyric antibiotic therapy.

Objetivo: Revisar la presentación clínica, microorganismos responsables de artritis séptica (AS) y de osteomielitis aguda (OM), así como el manejo agudo y seguimiento en población pediátrica menor de 16 años en la era post vacuna anti Haemophilus influenzae tipo B (Hib). Métodos: Revisión retrospectiva de casos clínicos acontecidos en nuestro Hospital entre los años 2004 y 2008 con el diagnóstico de OM y AS de origen infeccioso. Se incluyeron todos los casos registrados, con o sin manejo quirúrgico, y con fuente infecciosa tanto intra como extra hospitalaria. Resultados: Se obtuvo ficha clínica completa en 38 casos, 22OMA y 16 AS. El dolor y la impotencia funcional de extremidades inferiores, fueron los principales motivos de consulta en ambos grupos. Se logró aislar el agente en un 25 por ciento de las AS y un 54,5 por ciento de las OMA. El microorganismo más frecuente en OMA fue el Staphilococcus aureus. No se aisló este mismo, en AS. Discusión: La presentación clínica inicial de las infecciones osteoarticulares (IOA), es menos evidente en la actualidad que en otros tiempos. Debido a que la identificación del microorganismo causante de la infección no es inmediata, pensamos que la terapia antibiótica (ATB) empírica inicial es fundamental en el manejo de estas patologías. Sugerimos nuevos estudios que propongan un determinado manejo ATB empírico inicial universal.