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1.
Rev. med. Chile ; 150(6): 832-835, jun. 2022. ilus
Artigo em Espanhol | LILACS | ID: biblio-1424127

RESUMO

Multiple Myeloma (MM) is characterized by a clonal expansion of plasma cells in the bone marrow. These cells typically produce a monoclonal immunoglobulin, and its symptoms arise either from plasma cell infiltration in several organs, or secondary to the presence of a monoclonal protein peak. Symptoms can be summarized by the acronym CRAB (hypercalcemia, renal failure, anemia and bone lesions). Sometimes, in the setting of a protein secreting monoclonal gammopathy, formation of cryoglobulins develops. Cryoglobulins are plasma proteins that precipitate at low temperatures, forming a cold - induced precipitate at small vessels, causing a wide range of clinical manifestations. We report a female consulting for ulcers lasting 2 months in the left foot associated with purpuric lesions in both lower limbs. Protein electrophoresis showed a monoclonal peak in the gamma region. Bone marrow aspirate showed 27% of plasma cells with kappa chain restriction by cytometry. The presence of cryoglobulins was confirmed. The patient was treated with dexamethasone and bortezomib, with a progressive healing of lower limb lesions and disappearance of cryoglobulins. She was discharged in good conditions.


Assuntos
Humanos , Feminino , Vasculite/complicações , Crioglobulinemia/complicações , Crioglobulinemia/diagnóstico , Mieloma Múltiplo/complicações , Mieloma Múltiplo/diagnóstico , Criogéis , Bortezomib/uso terapêutico
2.
Rev Med Chil ; 150(6): 832-835, 2022 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-37906918

RESUMO

Multiple Myeloma (MM) is characterized by a clonal expansion of plasma cells in the bone marrow. These cells typically produce a monoclonal immunoglobulin, and its symptoms arise either from plasma cell infiltration in several organs, or secondary to the presence of a monoclonal protein peak. Symptoms can be summarized by the acronym CRAB (hypercalcemia, renal failure, anemia and bone lesions). Sometimes, in the setting of a protein secreting monoclonal gammopathy, formation of cryoglobulins develops. Cryoglobulins are plasma proteins that precipitate at low temperatures, forming a cold - induced precipitate at small vessels, causing a wide range of clinical manifestations. We report a female consulting for ulcers lasting 2 months in the left foot associated with purpuric lesions in both lower limbs. Protein electrophoresis showed a monoclonal peak in the gamma region. Bone marrow aspirate showed 27% of plasma cells with kappa chain restriction by cytometry. The presence of cryoglobulins was confirmed. The patient was treated with dexamethasone and bortezomib, with a progressive healing of lower limb lesions and disappearance of cryoglobulins. She was discharged in good conditions.


Assuntos
Crioglobulinemia , Mieloma Múltiplo , Vasculite , Feminino , Humanos , Mieloma Múltiplo/complicações , Mieloma Múltiplo/diagnóstico , Criogéis , Crioglobulinas/metabolismo , Bortezomib/uso terapêutico , Crioglobulinemia/complicações , Crioglobulinemia/diagnóstico , Vasculite/complicações
3.
Rev Med Chil ; 149(1): 98-102, 2021 Jan.
Artigo em Espanhol | MEDLINE | ID: mdl-34106140

RESUMO

Glomerular filtration rate (GFR) is routinely estimated using endogenous biomarkers due to the complexity of direct measurement methods. Cystatin C is a protease inhibitor produced in all nucleated cells. It is freely filtered and then catabolized by renal tubular cells. Therefore, plasma concentration of cystatin C depends primarily on GFR. Serum cystatin C is less affected by muscle mass, diet, race, gender and age than creatinine. In the general population, equations to estimate GFR based on cystatin C do not have a better performance than those based on creatinine. However, formulas that combine creatinine and cystatin C are more accurate and precise. Estimation of GFR based on cystatin C could be useful in populations in which creatinine value may be biased, such as people with extremely low or high muscle mass, cirrhosis and chronic cardiorenal syndrome. Due to its higher cost in comparison to creatinine, we recommend measuring cystatin C on these clinical situations and when a more accurate estimation of GFR is required.


Assuntos
Cistatina C , Rim , Biomarcadores , Creatinina , Taxa de Filtração Glomerular , Humanos
4.
Rev. méd. Chile ; 149(1): 98-102, ene. 2021. tab
Artigo em Espanhol | LILACS | ID: biblio-1389361

RESUMO

Glomerular filtration rate (GFR) is routinely estimated using endogenous biomarkers due to the complexity of direct measurement methods. Cystatin C is a protease inhibitor produced in all nucleated cells. It is freely filtered and then catabolized by renal tubular cells. Therefore, plasma concentration of cystatin C depends primarily on GFR. Serum cystatin C is less affected by muscle mass, diet, race, gender and age than creatinine. In the general population, equations to estimate GFR based on cystatin C do not have a better performance than those based on creatinine. However, formulas that combine creatinine and cystatin C are more accurate and precise. Estimation of GFR based on cystatin C could be useful in populations in which creatinine value may be biased, such as people with extremely low or high muscle mass, cirrhosis and chronic cardiorenal syndrome. Due to its higher cost in comparison to creatinine, we recommend measuring cystatin C on these clinical situations and when a more accurate estimation of GFR is required.


Assuntos
Humanos , Cistatina C , Rim , Biomarcadores , Creatinina , Taxa de Filtração Glomerular
5.
Perfusion ; 36(8): 825-831, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-33140691

RESUMO

BACKGROUND: Acute Kidney Injury is a complication in children with heart disease undergoing cardiac surgery with cardiopulmonary bypass. The aim of this study is to describe the behavior of KIM-1 (Kidney Injury Molecule) and NGAL (Neutrophil Gelatinase Associated Lipocalin) as early predictors of renal damage, comparing them with serum creatinine and creatinine clearance, in neonates undergoing cardiac surgery. METHODS: Twenty-one (21) neonates, under 4 kg, with complex congenital heart diseases, RACHS-1 > 3, without preoperative renal failure, were studied. Serum creatinine and creatinine clearance were measured preoperatively and at 24, 48, 72, 96 hours postoperatively. Urinary samples of KIM-1(pg/ml) and NGAL (ng/ml) were collected after induction of anesthesia at 24 and 48 hours post-operatively. RESULTS: nRIFLE criteria were used to divide cohorts in "NO AKI" (12 patients) and "AKI" (nine patients). In the AKI group, serum creatinine increased significantly and creatinine clearance decreased significantly at 24, 48, and 72 hours compared with their respective baseline values. There was no difference in KIM-1 and NGAL values between patients who developed AKI and those who did not at any measured time. CONCLUSIONS: The deterioration of renal function continues to be one of the most frequent complications in this population. In our study, biomarkers did not show any correlation with the appearance of AKI. It remains to be seen whether this behavior of the biomarkers is linked with the non-consistent release of these types of molecules in immature kidneys. It is likely that a larger panel of biomarkers together with other glomerular filtration rate assessment methods will provide more information about AKI diagnosis.


Assuntos
Injúria Renal Aguda , Procedimentos Cirúrgicos Cardíacos , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/etiologia , Proteínas de Fase Aguda , Biomarcadores , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Criança , Creatinina , Humanos , Recém-Nascido , Rim/fisiologia , Lipocalina-2 , Valor Preditivo dos Testes , Proteínas Proto-Oncogênicas
6.
Sci Rep ; 10(1): 16608, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33024174

RESUMO

The technique RT-qPCR for viral RNA detection is the current worldwide strategy used for early detection of the novel coronavirus SARS-CoV-2. RNA extraction is a key pre-analytical step in RT-qPCR, often achieved using commercial kits. However, the magnitude of the COVID-19 pandemic is causing disruptions to the global supply chains used by many diagnostic laboratories to procure the commercial kits required for RNA extraction. Shortage in these essential reagents is even more acute in developing countries with no means to produce kits locally. We sought to find an alternative procedure to replace commercial kits using common reagents found in molecular biology laboratories. Here we report a method for RNA extraction that takes about 40 min to complete ten samples, and is not more laborious than current commercial RNA extraction kits. We demonstrate that this method can be used to process nasopharyngeal swab samples and yields RT-qPCR results comparable to those obtained with commercial kits. Most importantly, this procedure can be easily implemented in any molecular diagnostic laboratory. Frequent testing is crucial for individual patient management as well as for public health decision making in this pandemic. Implementation of this method could maintain crucial testing going despite commercial kit shortages.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/diagnóstico , Pneumonia Viral/diagnóstico , RNA Viral/genética , RNA Viral/isolamento & purificação , Reação em Cadeia da Polimerase em Tempo Real , COVID-19 , Infecções por Coronavirus/virologia , Testes Diagnósticos de Rotina , Temperatura Alta , Humanos , Concentração de Íons de Hidrogênio , Indicadores e Reagentes , Pandemias , Pneumonia Viral/virologia , Kit de Reagentes para Diagnóstico/provisão & distribuição , SARS-CoV-2
7.
Rev Med Chil ; 146(3): 344-350, 2018 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-29999105

RESUMO

Glomerular filtration rate (GFR) is the best approximation to global renal function and its estimation is of great relevance for clinical practice. Since the measurement of GFR by reference methods is complex, costly and not widely available, its routine evaluation is performed using endogenous biomarkers. Within these, creatinine is the most commonly used. It allows the estimation of GFR by means of its clearance or by formulas based on its concentration on plasma. Creatinine measurement should be performed using enzimatic methods as they confer more accurate values than Jaffe methods, especially for normal and low creatinine levels.


Assuntos
Creatinina/sangue , Creatinina/urina , Taxa de Filtração Glomerular , Biomarcadores/sangue , Biomarcadores/urina , Humanos , Valores de Referência
8.
Rev Med Chil ; 146(1): 68-77, 2018 Jan.
Artigo em Espanhol | MEDLINE | ID: mdl-29806680

RESUMO

Recently, we have witnessed major improvements in cancer treatment. Early diagnosis and development of new therapies have reduced cancer-related mortality. However, these new therapies, along with greater patient survival, are associated with an increase in untoward effects, particularly in the cardiovascular system. Although cardiotoxicity induced by oncologic treatments affects predominantly the myocardium, it can also involve other structures of the cardiovascular system, becoming one of the main causes of morbidity and mortality in those who survive cancer. The main objective of cardio-oncology is to achieve the maximum benefits of oncologic treatments while minimizing their deleterious cardiovascular effects. It harbors the stratification of patients at risk of cardiotoxicity, the implementation of diagnostic tools (imaging techniques and biomarkers) for early diagnosis, preventive strategies and early treatment options for the complications. Herein, we discuss the basic knowledge for the implementation of cardio-oncology units and their role in the management of cancer patients, the diagnostic tools available to detect cardiotoxicity and the present therapeutic options.


Assuntos
Antineoplásicos/efeitos adversos , Cardiotoxicidade/etiologia , Cardiotoxicidade/prevenção & controle , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Radioterapia/efeitos adversos , Antineoplásicos/classificação , Biomarcadores , Humanos , Neoplasias/complicações , Neoplasias/tratamento farmacológico , Desenvolvimento de Programas , Fatores de Risco
9.
Rev. méd. Chile ; 146(3): 344-350, mar. 2018. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-961399

RESUMO

Glomerular filtration rate (GFR) is the best approximation to global renal function and its estimation is of great relevance for clinical practice. Since the measurement of GFR by reference methods is complex, costly and not widely available, its routine evaluation is performed using endogenous biomarkers. Within these, creatinine is the most commonly used. It allows the estimation of GFR by means of its clearance or by formulas based on its concentration on plasma. Creatinine measurement should be performed using enzimatic methods as they confer more accurate values than Jaffe methods, especially for normal and low creatinine levels.


Assuntos
Humanos , Creatinina/urina , Creatinina/sangue , Taxa de Filtração Glomerular , Valores de Referência , Biomarcadores/urina , Biomarcadores/sangue
10.
Rev. méd. Chile ; 146(1): 68-77, ene. 2018. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-902623

RESUMO

Recently, we have witnessed major improvements in cancer treatment. Early diagnosis and development of new therapies have reduced cancer-related mortality. However, these new therapies, along with greater patient survival, are associated with an increase in untoward effects, particularly in the cardiovascular system. Although cardiotoxicity induced by oncologic treatments affects predominantly the myocardium, it can also involve other structures of the cardiovascular system, becoming one of the main causes of morbidity and mortality in those who survive cancer. The main objective of cardio-oncology is to achieve the maximum benefits of oncologic treatments while minimizing their deleterious cardiovascular effects. It harbors the stratification of patients at risk of cardiotoxicity, the implementation of diagnostic tools (imaging techniques and biomarkers) for early diagnosis, preventive strategies and early treatment options for the complications. Herein, we discuss the basic knowledge for the implementation of cardio-oncology units and their role in the management of cancer patients, the diagnostic tools available to detect cardiotoxicity and the present therapeutic options.


Assuntos
Humanos , Radioterapia/efeitos adversos , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Cardiotoxicidade/etiologia , Cardiotoxicidade/prevenção & controle , Antineoplásicos/efeitos adversos , Biomarcadores , Fatores de Risco , Desenvolvimento de Programas , Neoplasias/complicações , Neoplasias/tratamento farmacológico , Antineoplásicos/classificação
11.
Acta bioeth ; 22(2): 195-202, nov. 2016.
Artigo em Espanhol | LILACS | ID: biblio-827606

RESUMO

La utilización de embriones humanos en la investigación biológica ha generado un debate ético desde la discusión ontológica, en relación a si se puede o no considerar al embrión persona humana. En este artículo se análiza el estatuto ontológico del embrión humano desde una perspectiva biológica, considerando las principales líneas de investigación que lo intervienen en América Latina. Adcionalmente, revisamos el aporte desde el estatuto legal del embrión humano en esta región y la postura desde la formalidad de la investigación cientifica en el cuidado de su utilización. Consideramos finalmente que en América Latina no se ha abordado de manera profunda la discusión en torno al estatuto del embrión humano como persona, quedando la discusión en una dimensión biológica.


The utilization of human embryos in the biological research has generated a bioethical debate from the ontological point of view about whether or not to consider the embryo as a human person. This paper review the ontological statute of the human embryo from a biological perspective considering the principal lines of investigation in Latin America. Complementary to discussion we check the contribution from the legal statute of the human embryo and the position from the formal scientific research in his utilization. Finally, we consider that, in Latin America, the discussion has not been approached in a deep way about the statute of the human embryo as person, staying the discussion in a dimension of the biological thing.


A utilização de embriões humanos na investigação biológica tem gerado um debate ético a partir da discussão ontológica, com relação a se deveria ou não considerar o embrião pessoa humana. Neste artigo se analisa o estatuto ontológico do embrião humano a partir de uma perspectiva biológica, considerando as principais linhas de investigação de intervenção no embrião na América Latina. Adicionalmente, revisamos a contribuição a partir do estatuto legal do embrião humano nesta região e a postura a partir da formalidade da investigação cientifica no cuidado de sua utilização. Consideramos finalmente que na América Latina não se tem abordado de maneira profunda a discussão em torno do estatuto do embrião humano como pessoa, tornando-se a discussão uma dimensão biológica.


Assuntos
Humanos , Bioética , Pesquisas com Embriões/ética , Embrião de Mamíferos , Pessoalidade , Pesquisas com Embriões/legislação & jurisprudência , América Latina
12.
World J Gastroenterol ; 19(2): 316-8, 2013 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-23345958

RESUMO

The most frequent cause of pseudomembranous colitis is Clostridium difficile (C. difficile) infection. This type of colitis is characterized by an endoscopic pattern of numerous small, yellowish or whitish plaques diffusely distributed, which typically compromises the rectum extending to proximal colon. Occasionally, the pseudomembranes compromise only the transverse or right colon, but their exclusive localization over polyps has not been reported. In this case report we have described a patient with symptoms compatible with C. difficile infection and positive for C. difficile toxigenic culture. Colonoscopy examination showed two small polyps with a whitish surface, and histopathological analysis confirmed them to be pseudomembranes over tubular adenomas. The rest of the colonic mucosa was normal and no other cause was demonstrated. We suggest that this particular distribution might be due to a higher affinity for dysplastic cells such as adenomatous polyps of colon by C. difficile and/or its toxins.


Assuntos
Pólipos Adenomatosos/epidemiologia , Clostridioides difficile , Neoplasias do Colo/epidemiologia , Enterocolite Pseudomembranosa/epidemiologia , Pólipos Adenomatosos/diagnóstico , Idoso de 80 Anos ou mais , Anti-Infecciosos/uso terapêutico , Neoplasias do Colo/diagnóstico , Colonoscopia , Comorbidade , Enterocolite Pseudomembranosa/diagnóstico , Enterocolite Pseudomembranosa/tratamento farmacológico , Feminino , Humanos , Metronidazol/uso terapêutico
13.
Rev Chilena Infectol ; 29(4): 406-11, 2012 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-23096540

RESUMO

Blood culture is considered the "gold standard" for the diagnosis of bacteremia, critical condition with high morbidity and mortality. Because of its importance, it is estimated that the blood culture is a critical test that requires close monitoring on the quality with which the process is performed. The objective of this work is to show the results of the monitoring carried out during the past three years, of 5 quality indicators of blood cultures in the laboratory of the Hospital Clínico de la Pontificia Universidad Católica de Chile, considering pre-analytical, analytical and post-analytical aspects. In the 3 years monitored the mean contamination was 0,7%, 46% of adult bottles had adequate volume, match between Gram stain with final identification was 99.4%, 100% of correct participations were achieved in surveys of external quality control and Gram staining notification before 1 hour was 88.7%. With regard to proposed aims, in 2011 the laboratory complies with all, except the percentage of bottles with appropriate volume of blood inoculated. This indicator is very low and should be corrected as soon as possible since it is known that it is an important condition for optimum performance of blood cultures.


Assuntos
Bacteriemia/diagnóstico , Sangue/microbiologia , Controle de Qualidade , Técnicas Bacteriológicas/normas , Coleta de Amostras Sanguíneas , Chile , Contaminação de Equipamentos/estatística & dados numéricos , Violeta Genciana , Hospitais Universitários , Humanos , Laboratórios Hospitalares/normas , Fenazinas
14.
Rev. chil. infectol ; 29(4): 406-411, ago. 2012. tab
Artigo em Espanhol | LILACS | ID: lil-649828

RESUMO

Blood culture is considered the "gold standard" for the diagnosis of bacteremia, critical condition with high morbidity and mortality. Because of its importance, it is estimated that the blood culture is a critical test that requires close monitoring on the quality with which the process is performed. The objective of this work is to show the results of the monitoring carried out during the past three years, of 5 quality indicators of blood cultures in the laboratory of the Hospital Clínico de la Pontificia Universidad Católica de Chile, considering pre-analytical, analytical and post-analytical aspects. In the 3 years monitored the mean contamination was 0,7%, 46% of adult bottles had adequate volume, match between Gram stain with final identification was 99.4%, 100% of correct participations were achieved in surveys of external quality control and Gram staining notification before 1 hour was 88.7%. With regard to proposed aims, in 2011 the laboratory complies with all, except the percentage of bottles with appropriate volume of blood inoculated. This indicator is very low and should be corrected as soon as possible since it is known that it is an important condition for optimum performance of blood cultures.


El hemocultivo es el "estándar de oro" para el diagnóstico de bacteriemia, condición grave de alta morbi-mortalidad. Por esto, se estima que el hemocultivo es un examen crítico, que requiere monitorización de su calidad. El objetivo de este trabajo es mostrar los resultados de la monitorización de 3 años de 5 indicadores de calidad del hemocultivo implementados en nuestro hospital. El porcentaje promedio de contaminación de las botellas para hemocultivo fue 0,7%, el porcentaje de botellas de adultos con volumen adecuado fue 46%, la concordancia de la tinción de Gram con la identificación final correspondió a 99,4%, el 100% de las participaciones en encuestas de control de calidad externo fueron correctas y 88,7% de los avisos de valores de alerta de la tinción de Gram fueron realizados antes de 1 hora. En el año 2011 se cumplió con las metas propuestas por el laboratorio para todos los indicadores, excepto con el porcentaje de botellas con volumen apropiado de sangre. Este último, se encuentra muy por debajo de la meta y debe ser mejorado a la brevedad, ya que el volumen de sangre cultivada es el factor más importante para obtener un rendimiento óptimo del hemocultivo.


Assuntos
Humanos , Bacteriemia/diagnóstico , Sangue/microbiologia , Controle de Qualidade , Coleta de Amostras Sanguíneas , Técnicas Bacteriológicas/normas , Chile , Contaminação de Equipamentos/estatística & dados numéricos , Violeta Genciana , Hospitais Universitários , Laboratórios Hospitalares/normas , Fenazinas
16.
Rev Chilena Infectol ; 29(2): 149-55, 2012 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-22689028

RESUMO

OBJECTIVE: To describe antifungal susceptibility testing surveillance (December 2004-September 2010) in Candida spp., for amphotericin B, fluconazole and voriconazole, at the Laboratorio de Microbiología, Pontificia Universidad Católica de Chile. METHOD: The study was performed utilizing E test and included yeasts from invasive origin and isolates in which antifungal susceptibility testing was asked for by the patient's physician. RESULTS: The yeasts were mainly recovered from urine samples (n: 64), blood cultures (n: 51) and secretions (n: 24). Two hundred ninety three isolates were studied: C. albicans (38%), C. glabrata (30%), C. tropicalis (11%), C. parapsilosis (10%), C. krusei (4%) and others (7%). All Candida species were 100% susceptible to amphotericin B, except C. krusei (1/12). Fluconazole's global susceptibility in C. albicans was 91.8%, but 100% in isolates from blood cultures versus 76% in isolates from urine. C. tropicalis was 93.9% susceptible to fluconazole, C. parapsilosis, 90% and C. glabrata 30.3%. C. krusei had no susceptible isolates to fluconazole. Voriconazole resistance was mainly present in C. glabrata (11.5%). CONCLUSIONS: We recommend the study of antifungal susceptibility in isolates from invasive origin, selected urine strains and C. glabrata. Fluconazole remains effective in C. albicans from blood.


Assuntos
Anfotericina B/farmacologia , Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Fluconazol/farmacologia , Pirimidinas/farmacologia , Triazóis/farmacologia , Candida/classificação , Candida/isolamento & purificação , Chile , Estudos de Coortes , Farmacorresistência Fúngica , Humanos , Testes de Sensibilidade Microbiana , Estudos Retrospectivos , Voriconazol
17.
Rev. chil. infectol ; 29(2): 149-155, abr. 2012. graf, tab
Artigo em Espanhol | LILACS | ID: lil-627227

RESUMO

Objective: To describe antifungal susceptibility testing surveillance (December 2004-September 2010) in Candida spp., for amphotericin B, fluconazole and voriconazole, at the Laboratorio de Microbiología, Pontificia Universidad Católica de Chile. Method: The study was performed utilizing E test and included yeasts from invasive origin and isolates in which antifungal susceptibility testing was asked for by the patient's physician. Results: The yeasts were mainly recovered from urine samples (n: 64), blood cultures (n: 51) and secretions (n: 24). Two hundred ninety three isolates were studied: C. albicans (38%), C. glabrata (30%), C. tropicalis (11%), C. parapsilosis (10%), C. krusei (4%) and others (7%). All Candida species were 100% susceptible to amphotericin B, except C. krusei (1/12). Fluconazole's global susceptibility in C. albicans was 91.8%, but 100% in isolates from blood cultures versus 76% in isolates from urine. C. tropicalis was 93.9% susceptible to fluconazole, C. parapsilosis, 90% and C. glabrata 30.3%. C. krusei had no susceptible isolates to fluconazole. Voriconazole resistance was mainly present in C. glabrata (11.5%). Conclusions: We recommend the study of antifungal susceptibility in isolates from invasive origin, selected urine strains and C. glabrata. Fluconazole remains effective in C. albicans from blood.


Objetivo: Describir la susceptibilidad antifúngica in vitro (anfotericina B, fluconazol y voriconazol) de aislados de Candida spp., observada desde diciembre 2004 a septiembre 2010 en el Laboratorio de Microbiología de la Pontificia Universidad Católica de Chile. Material y Método: Se realizó estudio de susceptibilidad mediante E test® a todas las cepas invasoras y a aquellas en que se solicitara dirigidamente antifungigrama (aislados locales o derivados desde otros centros). Resultados: Se estudiaron 293 aislados, principalmente de muestras de orina (n: 64), hemocultivos (n: 51) y secreciones (n: 24). Las especies correspondieron a C. albicans (38%), C. glabrata (30%), C. tropicalis (11%), C. parapsilosis (10%), C. krusei (4%) y otras (7%). Hubo 100% de susceptibilidad a anfotericina B, excepto en C. krusei (1/12 resistente). La susceptibilidad a fluconazol fue: C. albicans 91,8% (100% en aislados de sangre vs 76% en orina); C. tropicalis, 93,9%, C. parapsilosis, 90% y C. glabrata 30,3%. Candida krusei, no tuvo aislados susceptibles a fluconazol. La resistencia a voriconazol se evidenció fundamentalmente en C. glabrata (11,5%). Conclusiones: Recomendamos realizar estudio de susceptibilidad en aislados de muestras invasoras, casos seleccionados de cepas de orina y ante sospecha de C. glabrata. Fluconazol mantiene efectividad en C. albicans proveniente de sangre.


Assuntos
Humanos , Anfotericina B/farmacologia , Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Fluconazol/farmacologia , Pirimidinas/farmacologia , Triazóis/farmacologia , Chile , Estudos de Coortes , Candida/classificação , Candida/isolamento & purificação , Farmacorresistência Fúngica , Testes de Sensibilidade Microbiana , Estudos Retrospectivos
18.
Int J Dermatol ; 51(3): 283-5, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22348562

RESUMO

BACKGROUND: Trichophyton mentagrophytes var. erinacei is a zoophilic dermatophyte transmitted by hedgehogs which human infections manifest as highly inflammatory and pruritic eruptions. METHODS: We report a 21-year-old woman who presented with a two-week history of a pruritic scaly erythematous plaque on the nose. The patient had kept hedgehogs as pets, and one had bitten her on the tip of the nose two months prior to the appearance of the nasal lesion. RESULTS: Fungal culture from the scales on the tip of the patient's nose was compatible with T. mentagrophytes var. erinacei. The strains isolated from cultures made from samples taken from the noses and ears of the pet hedgehogs were morphologically similar to the strain isolated from the patient. Morphological identification was confirmed by sequencing the internal transcribed spacer. The lesion was diagnosed as tinea faciei, and therapy was initiated with topical and systemic terbinafine 250mg/day for eight weeks, which resulted in complete improvement. CONCLUSIONS: Trichophyton mentagrophytes var. erinacei is the most common dermatophyte isolated in hedgehogs. Usually T. mentagrophytes var. erinacei infection manifests as an extremely inflammatory and pruritic eruption that is confined to the site of contact with the hedgehog. Although the identification of T. mentagrophytes by traditional methods is possible, identification by ITS region analysis is a fast, simple, and increasingly available method. The increasing frequency of the practice of keeping exotic animals as pets has resulted in the emergence of several zoonotic diseases that can potentially be transmitted to humans.


Assuntos
Dermatoses Faciais/etiologia , Ouriços/microbiologia , Tinha/transmissão , Trichophyton/isolamento & purificação , Adulto , Animais , Mordeduras e Picadas/microbiologia , Chile , Dermatoses Faciais/diagnóstico , Feminino , Humanos , Tinha/diagnóstico , Adulto Jovem
19.
Cent Eur J Public Health ; 19(1): 46-53, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21526657

RESUMO

Food poisoning and non-food poisoning illnesses due to C. perfringens (by enterotoxin production) have been associated to chromosomal or plasmidic location of the cpe gene, respectively. Clostridial pathogenicity has been correlated to protease and azoreductase production. The aim of this work was: i) to assess the sanitary-hygienic quality of dehydrated soups (100 samples) consumed in San Luis - Argentina; ii) to verify the presence of C. perfringens in these food products using the "Most Probable Number" method (MPN) and plate-counting methods; iii) to characterise enterotoxigenicity in strain isolates by RPLA; iv) to determine the chromosomal or plasmidic location of the cpe gene in enterotoxigenic strains previously isolated from food in our lab, using PCR; v) to correlate chromosomal cpe and spore heat-resistance; vi) to compare protease activity in cpe+ and cpe- strains; and vii) to compare azoreductase activity in cpe+ and cpe- strains. Twenty-six isolates had a count a 3-43 bacteria g(-1) count using MPN; 7.7% exceeded the Argentine Food Code (CAA) limit. All isolates showed protease activity: enterotoxigenic isolates had higher protease activity than non-enterotoxigenic isolates. All isolates showed azoreductase activity: enterotoxigenic isolates had higher activity and shorter reducing times. Enterotoxigenic isolates showed chromosomal location for the gene responsible for the enterotoxin.


Assuntos
Toxinas Bacterianas/genética , Clostridium perfringens/genética , Clostridium perfringens/metabolismo , Contaminação de Alimentos , Microbiologia de Alimentos , Genes Bacterianos , Argentina/epidemiologia , Técnicas Bacteriológicas , Cromossomos Bacterianos/genética , Clostridium perfringens/isolamento & purificação , Humanos , Plasmídeos
20.
Food Microbiol ; 28(1): 21-8, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21056771

RESUMO

The characterization of phenotypic and genotypic virulence markers of Yersinia enterocolitica strains belonging to biotypes (B) 1A, 2 and 3, mostly isolated from food in San Luis, Argentina, and the assessment of their genotypic diversity using PFGE and PCR ribotyping, were performed in our laboratory for the first time. Thirty five Y. enterocolitica strains, two reference strains and 33 strains isolated in our laboratory were studied. The presence of virF, ail, ystA, and myfA genes was investigated by multiplex PCR. The pathogenic potential of B1A strains, the most predominant biotype of Y. enterocolitica strains isolated from meat in our region, was investigated by simple PCR. Four B1A strains were positive for ystB gene. Four Y. enterocolitica 2/O:9 (bio/serotype) and two 3/O:5 strains isolated in our laboratory showed virulence-related results in the phenotypic tests and multiplex PCR. A good correlation between the expression of virulence markers and their corresponding genotypes was observed for most strains. Sixteen genomic types (GT) and 9 different intergenic spacer region (SR) groups were generated by PFGE and PCR ribotyping, respectively. In both cases the Y. enterocolitica 2/O:9 strains were separately clustered from 1A and 3/O:5 strains. Meat foods might be vehicles of transmission of pathogenic Y. enterocolitica strains in our region.


Assuntos
Eletroforese em Gel de Campo Pulsado/métodos , Genes Bacterianos , Produtos da Carne/microbiologia , Reação em Cadeia da Polimerase/métodos , Ribotipagem/métodos , Yersinia enterocolitica/isolamento & purificação , Argentina , Microbiologia de Alimentos , Genótipo , Fenótipo , Yersinia enterocolitica/classificação , Yersinia enterocolitica/genética , Yersinia enterocolitica/patogenicidade
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