RESUMO
Introducción: El término micobacterias no tuberculosas (MNT) incluye distintas especies ambientales capaces de enfermar humanosy/o animales incluso mediante una probable transmisión zoonótica Objetivos. Determinar: la importancia clínica de varias especies del género Mycobacterium y la diversidad genética del Complejo M. avium (MAC), la sensibilidad bacteriana in vitro yel éxito del tratamiento especifico. Materiales y Métodos: Recolección de datos clínicos, epidemiológicos y aislamientos en el periodo 2009-2016; identificación molecular de los aislamientos; determinación de la sensibilidad bacteriana in vitro y de la diversidad genética del MAC; evaluación del tratamiento. Resultados: Fueron diagnosticados 225 casos de micobacteriosis, con prevalencia estable ≈ 6% por año, y 22 especies recuperadas: 4 de rápido desarrollo aisladas de 66 pacientes y 18 de lento desarrollo. MAC fue aislado en 95 casos, 40 M. avium hominissuis, 51 M. intracellulare, 3 M. chimaera, 1 M. colombiense. Se observó mayor probabilidad de enfermar por M. intracellulare en pacientes tratados previamente por tuberculosis (TB). Los pacientes HIV+ tuvieron riesgo incrementado de enfermedad causada por M. avium hominissuis. Los aminoglucósidos, fluoroquinolonas y macrólidos fueron las drogas más activas frente a la mayoría de las MNT. Aproximadamente la mitad de los casos curaron. Conclusiones: M. intracellulare, M. aviumhominissuis con una gran variabilidad genética, y M. abscessus fueron los patógenos más frecuentemente hallados. Un hallazgo importante fue el de casos de enfermedad mixta TB+MNT. Estos pacientes requirieron una terapia con agregado de drogas de segunda línea al esquema terapéutico para TB habiendo curado la mayoría de ellos.
Introduction: The term non-tuberculous mycobacteria (NTM) includes different ambient species capable of sickening humans and/or animals, even by means of a potential zoonotic transmission. Objectives: To determine: The clinical importance of several species within the genus Mycobacterium and the genetic diversity of the M. avium complex (MAC), the in vitro bacterial sensitivity and the success of the specific treatment. Materials and Methods: Collection of clinical and epidemiologic data and information about isolates of the 2009-2016 period; molecular identification of the isolates; determination of the in vitro bacterial sensitivity and genetic diversity of the MAC; treatment evaluation. Results: 225 mycobacteriosis cases were diagnosed, with a stable prevalence of ≈6% per year and 22 recovered species: 4 rapidly growing species isolated from 66 patients and 18 slowly growing species. The MAC was isolated in 95 cases, M. avium hominissuis - 40 cases, M. intracellulare - 51 cases, M. chimaera - 3 cases and M. colombiense - 1 case. We observed a greater probability of getting sick from M. intracellulare in patients previously treated for tuberculosis (TB). HIV-positive patients had a greater risk of falling ill from M. avium hominissuis. Aminoglycosides, fluoroquinolones and macrolides were the most active drugs against most NTM. Approximately half of the cases healed. Conclusions: M. intracellulare, M. aviumhominissuis with great genetic variability and M. abscessus were the most commonly found pathogens. The cases of TB+NTM mixed disease were an important finding. For treating these patients, it was necessary to add second line drugs to the therapeutic regimen for TB; and most of them healed.
Assuntos
Bactérias , Variação Genética , Micobactérias não TuberculosasRESUMO
Introduction: The term non-tuberculous mycobacteria (NTM) includes different ambient species capable of sickening humans and/or animals, even by means of a potential zoonotic transmission. Objectives: To determine: The clinical importance of several species within the genus Mycobacterium and the genetic diversity of the M. avium complex (MAC), the in vitro bacterial sensitivity and the success of the specific treatment. Materials and Methods: Collection of clinical and epidemiologic data and information about isolates of the 2009-2016 period; molecular identification of the isolates; determination of the in vitro bacterial sensitivity and genetic diversity of the MAC; treatment evaluation. Results: 225 mycobacteriosis cases were diagnosed, with a stable prevalence of ≈6% per year and 22 recovered species: 4 rapidly growing species isolated from 66 patients and 18 slowly growing species. The MAC was isolated in 95 cases, M. avium hominissuis - 40 cases, M. intracellulare - 51 cases, M. chimaera - 3 cases and M. colombiense - 1 case. We observed a greater probability of getting sick from M. intracellulare in patients previously treated for tuberculosis (TB). HIV-positive patients had a greater risk of falling ill from M. avium hominissuis. Aminoglycosides, fluoroquinolones and macrolides were the most active drugs against most NTM. Approximately half of the cases healed. Conclusions: M. intracellulare, M. aviumhominissuis with great genetic variability and M. abscessus were the most commonly found pathogens. The cases of TB+NTM mixed disease were an important finding. For treating these patients, it was necessary to add second line drugs to the therapeutic regimen for TB; and most of them healed
Assuntos
Bactérias , Variação Genética , Micobactérias não TuberculosasRESUMO
BACKGROUND: Trichinellosis is a parasitic zoonosis caused by ingestion of infected meat containing cysts of Trichinella spp. OBJECTIVES: To analyze the epidemiological, clinical and laboratory findings of trichinellosis patients in our center and compare the results with those from published series. To analyze the relationship between the clinical symptoms and laboratory findings. MATERIALS AND METHODS: The clinical records of 127 patients were retrospectively analyzed. RESULTS: Epidemiological: 61% were male and mean age was 32 years; 95% were associated with other cases. The food implicated was always pork. Clinical: 45% presented gastrointestinal symptoms and 98% systemic symptoms. Three patients required intensive care unit hospitalization and one died. In 53%, treatment consisted of associated antiparasitic and anti-inflammatory drugs. Laboratory: 59% presented leukocytosis and 72% absolute eosinophilia. Creatine phosphokinase was elevated in 62%, lactic dehydrogenase in 56% and glutamic-oxaloacetic transaminase (GOT) in 30%. Among 52 patients, 65% had positive serology; trichinoscopy of food samples was positive in three outbreaks. The population studied had a mean of 5 signs and/or symptoms. The patient group with more than 5 signs and/or symptoms presented higher white blood cell counts and GOT levels (p < 0.05) CONCLUSIONS: Our results were comparable to those of other series; however, there was a low rate of complications. An association was found between a larger number of signs and symptoms and higher leukocyte counts and GOT levels. The relevance of these findings should be assessed in future studies. There is no agreement as to the best therapeutic option, a fact reflected in the various treatment modalities seen in our study.