Clinical and pathological findings of Rhodococcus equi infection in foals / Achados clínicos e patológicos da infecção por Rhodococcus equi em potros

Infection by Rhodococcus equi is considered one of the major health concerns for foals worldwide. In order to better understand the disease's clinical and pathological features, we studied twenty cases of natural infection by R. equi in foals. These cases are characterized according to their clinical and pathological findings and immunohistochemical aspects. Necropsy, histologic examination, bacterial culture, R. equi and Pneumocystis spp. immunohistochemistry were performed. The foals had a mean age of 60 days and presented respiratory signs (11/20), hyperthermia (10/20), articular swelling (6/20), prostration (4/20), locomotor impairment (3/20) and diarrhea (3/20), among others. The main lesions were of pyogranulomatous pneumonia, seen in 19 foals, accompanied or not by pyogranulomatous lymphadenitis (10/20) and pyogranulomatous and ulcerative enterocolitis (5/20). Pyogranulomatous osteomyelitis was seen in 3 foals, one of which did not have pulmonary involvement. There was lymphoplasmacytic (4/20), lymphoplasmacytic and neutrophilic (1/20) or pyogranulomatous arthritis (1/20), affecting multiple or singular joints. Immunohistochemistry revealed to be a valuable tool for the detection of R. equi, confirming the diagnosis in all cases. Furthermore, pulmonary immunostaining for Pneumocystis spp. demonstrates that a coinfection with R. equi and this fungal agent is a common event in foals, seen in 13 cases.(AU)

Infecção por Rhodococcus equi é considerado um dos maiores problemas sanitários para potros em todo o mundo. Para melhor compreender a apresentação clínica e patológica da enfermidade, foram avaliados vinte casos de infecção natural por R. equi em potros. Os casos são caracterizados de acordo com seus achados clínicos e patológicos e aspectos imuno-histoquímicos. Foram realizados exames de necropsia, histologia, bacteriologia e imuno-histoquímica para R. equi e Pneumocystis spp. Os potros tinham idade media de 60 dias e apresentaram sinais respiratórios (11/20), hipertermia (10/20), aumento de volume articular (6/20), prostração (4/20), distúrbios locomotores (3/20) e diarreia (3/20), entre outros. As lesões mais importantes eram pneumonia piogranulomatosa, vista em 19 potros, acompanhada ou não por linfadenite piogranulomatosa (10/20) e enterocolite ulcerativa (5/20). Osteomielite piogranulomatosa foi constatada em três potros, um dos quais não apresentava envolvimento pulmonar. Artrites afetando uma ou múltiplas articulações eram caracterizadas por infiltrado linfoplasmocítico (4/20), linfoplasmocítico e neutrofílico (1/20) e piogranulomatoso (1/20). A imuno-histoquímica demonstrou ser uma ferramenta valiosa na detecção de R. equi, permitindo confirmar o diagnóstico em todos os casos avaliados. Além disso, a imuno-histoquímica para Pneumocystis spp. demonstra que a coinfecção por R. equi e o agente fúngico é um evento frequente em potros, constatado em 13 casos.(AU)

Emergence of coryneform bacteria as pathogens in nosocomial surgical site infections in a tertiary care hospital of North India

A prospective study was conducted to assess the role of coryneform bacteria in surgical site infections among obstetric and gynecological patients undergoing surgery. The surgery was graded according to the degree of contamination, and surgical site infections [SSIs] were classified as superficial or deep. Pus samples were collected from SSIs according to rigorous aseptic precautions, and the quality of specimens was assessed by Q-score. A detailed clinical and treatment history was elicited from all patients. The samples were processed using standard protocols. Coryneform bacteria were considered significant pathogens only if they fulfilled rigorous clinical and microbiological criteria. Antibiotic susceptibility testing was performed using the Kirby-Bauer method according to the CLSI guidelines. In total, 127 patients developed SSIs among 882 postoperative patients. Of these, 89 [70.1%] were culture positive: 40 [44.9%] were Gram-positive cocci, 27 [30.3%] were coryneform, and 22 [24.7%] were Gram-negative bacilli. All coryneform-infected patients had fever and post-operative wound dehiscence leading to a prolonged hospital stay. The most commonly isolated organism was Staphylococcus aureus [33.7%], followed by Corynebacterium amycolatum [11.2%], Escherichia coli [8.9%], Citrobacter spp. [7.8%] and coagulase-negative Staphylococci [6.7%]. In our study, 45.5% were ESBL producers, 18.2% were Amp C producers, and 40% were MRSA. All the coryneform bacteria were multidrug resistant, and 51.8% of isolates were sensitive to only gatifloxacin and vancomycin. Symptomatic improvement was observed in all coryneform-infected patients after the administration of appropriate therapy. Coryneform bacteria appear to be emerging as significant nosocomial surgical site pathogens. The high level of multidrug resistance observed in coryneform bacteria in our study is cause for alarm

Prevalência de gardnerella e mobiluncus em exames de colpocitologia em Tomé-Açu, Pará / Prevalence of gardnerella and mobiluncus in vaginal cytology examinations in Tome-Açu-Pará

Objetivo: a Gardnerella vaginalis, isoladamente ou associada ao Mobiluncus sp., é um dos principais agentes causadores de infecções em mulheres em idade reprodutiva, seja pela falta de hábitos de higiene adequados, número de parceiros sexuais ou desequilíbrios da microflora vaginal. Assim, buscou-se verificar a prevalência de G vaginalis e/ou Mobiluncus sp., associadas às condições sócio-culturais em mulheres atendidas no Hospital de Quatro Bocas de Tomé-Açu - Pará, através de exame preventivo de câncer de colo do útero. Método e Resultados: analisados materiais cervico-vaginais e informações sócio-culturais de 156 mulheres, com faixas etárias de 17 e 73 anos, período de outubro de 2003 a julho de 2004, para o diagnóstico de prevenção de câncer ginecológico. Todas as amostras foram processadas de modo convencional e analisadas no Laboratório de Citopatologia da Universidade Federal do Pará por três observadores (estudo cego). Como resultados verificou-se que das 156 mulheres pesquisadas , a maior prevalência estava associada à G vaginalis (48,15%), faixa etária de 21 a 30 anos, ou pela associação G vaginalis e Mobiluncus sp (36,36%). Em relação ao grau de escolaridade e ocupação, a maior prevalência ocorreu em mulheres com r grau incompleto (47,37%), com atividades do lar (21,05%) e comércio (22,81%). Conclusões: estes dados reforçam pesquisas que relacionam a prevalência de G vaginalis e/ou Mobiluncus sp, em mulheres com vida sexual e menor grau de escolaridade.

Objective: gardnerella vaginalis, alone or associated to Mobiluncus sp., is one of the main etiological agents ofinfection in women of reproductive age, due to lack of appropriate hygiene habits, number of sexual partners ar imbalance of the vaginal microbiota. Therefore, our objective was to assess the prevalence of bacterial vaginosis caused by G vaginalis and/or Mobiluncus sp., and associate this to the sociocultural conditions in women attended ai Hospital de Quatro Bocas in Tomé-Açu - Pará - Brazil, through gynecological cancer screening. Methods and Results: cervico-vaginal smears and socio-cultural information of 156 women aged 17 to 73 were analyzedfor diagnosis and prevention of gynecological cancer from October 2003 to July 2004. Ali samples were processed in the conventional way and analyzed at Universidade Federal do Pará's Laboratory of Cytopathology by three observers (a blind study). Among ali 156 women, the largest prevalence was associated to G vaginalis (48,15%) in 21 to 30- year-old women, ar to the association of G vaginalis and Mobiluncus sp (36,36%). As for the occupation and instruction degree, the infection was most prevalent in women with incomplete primary school (47,37%), housewives (21,05%) and market workers (22,81 %). Conclusions: our data reaffirm previous researches that relate the prevalence ofbacterial vaginosis caused by G vaginalis and /or Mobiluncus sp. to low instruction degree in sexually active women.

Estudio clínico y microbiológico de los micetomas observados en el Hospital de Infecciosas Francisco J. Muñiz en el período 1989-2004 / Clinical and microbiological study of mycetomas at the Muñiz Hospital of Buenos Aires between 1989 and 2004

Se presentan las características clínicas, microbiológicas y los resultados del tratamiento de 76 casos de micetomas observados en el período 1989-2004 en el Hospital Muñiz. Cuarenta y nueve fueron varones y 27 mujeres, con una edad promedio de 43,4 años. La mayor parte de los pacientes adquirió la infección en nuestro país, las provincias más afectadas fueron Santiago del Estero con 31 casos y el Chaco con 11; 8 enfermos procedían del exterior, 6 de Bolivia y 2 de Paraguay. El promedio de evolución de la enfermedad fue de 9,2 años. Las localizaciones más comunes fueron las de los miembros inferiores: pies 63, tobillos 3 y rodillas 2. Se comprobó compromiso óseo en 48 casos y adenomegalias en 5. Fueron identificados los siguientes agentes causales: Madurella grisea 29 casos, Actinomadura madurae 26, Scedosporium apiospermum 5, Nocardia brasiliensis 5, Acremoniun spp. 4 (Acremonium falciforme 2, Acremonium kiliense 1 y Acremonium recifei 1), Madurella mycetomatis 3, Fusarium solani 2, Nocardia asteroides y Streptomyces somaliensis 1 caso cada uno. Los tratamientos más frecuentemente utilizados fueron ketoconazol o itraconazol en los micetomas maduromicósicos y la asociación de cotrimoxazol con ciprofloxacina o amicacina en los micetomas actinomicéticos. La amputación del miembro afectado se realizó en 6 casos, 25 pacientes alcanzaron la remisión clínica completa y 34 presentaron mejorías importantes.

This work presents clinical, microbiological and outcome data collected from 76 patients with mycetomas at the Muñiz Hospital from 1989 to 2004. Forty-nine patients were male and 27 female; the mean age was 43.4 years. The majority of the patients acquired the infection in Argentina: the most affected provinces were Santiago del Estero with 31 cases, and Chaco with 11; 8 cases came from other countries (Bolivia 6 and Paraguay 2). The mean evolution of the disease was 9.2 years. The most frequently observed sites were: feet 63 cases, ankles 3, and knees 2. Forty-eight patients had bone lesions and 5, adenomegalies. The following etiological agents were identified: Madurella grisea 29 cases, Actinomadura madurae 26, Scedosporium apiospermum 5, Nocardia brasiliensis 5, Acremonium spp. 4 (Acremonium falciforme 2, Acremonium kiliense 1, Acremonium recifei 1), Madurella mycetomatis 3, Fusarium solani 2, Nocardia asteroides 1 and Streptomyces somaliensis 1. The main drugs used in the treatments were ketoconazole and itraconazole for maduromycotic mycetomas, and cotrimoxazole associated with ciprofloxacin or amikacin for actinomycetic mycetoma. Six patients had to undergo amputation, 25 cases achieved complete clinical remission and 34 showed remarkable improvement.

Repeated isolation of chemoautotrophic nocardioform bacteria from fish epizootic ulcerative syndrome.

Nocardioform actinomycetic organisms were present regularly in, and isolated repeatedly from, different varieties of fish affected with epizootic ulcerative syndrome lesions of dermis, muscle, subcutaneous tissues and internal organs. These acid-fast bacilli, resembling human and rat leprosy bacilli, together with other actinomycotic bodies, appeared to explain the characteristic macrophage granuloma observed in such lesions, similar to those of humans. These isolates possessed fundamental similarities to the human isolates of chemoautotrophic nocardioform bacteria reported earlier.