Purple urine bag syndrome: case report / Síndrome do saco coletor de urina roxo: relato de caso

ABSTRACT A 65-year-old male with a history of urinary tract trauma requiring cystotomy and chronic bladder catheterization, presenting with chronic and uninvestigated changes in the color of the urine bag system, with no urine color change, and positive urine culture for Proteus mirabilis . These characteristics refer to the purple urine bag syndrome, a not weel-known condition, with a benign course in most cases, and associated with urinary tract infection in patients with chronic bladder catheterization. Although it is characterized by marked changes, it is underdiagnosed by healthcare professionals.

RESUMO Homem de 65 anos com história de trauma do sistema urinário, sendo necessário cistotomia e sondagem vesical crônica, apresentando alterações crônicas e não investigadas da cor do sistema coletor de urina, sem alteração da cor da urina, e urocultura positiva para Proteus mirabilis . Tais características remetem à síndrome do saco coletor de urina roxo, uma entidade pouco conhecida, de curso benigno na maioria da vezes, associada à infecção urinária em paciente com cateterismo vesical de demora. Embora seja caracterizada por alterações marcantes, é subdiagnosticada pelos profissionais de saúde.

Agentes etiológicos y su sensibilidad antimicrobiana en urocultivos confirmatorios de infección urinaria en un servicio de urgencia de pediatría / Etiological agents and its antimicrobial sensitivity in confirmatory urine cultures in a pediatric emergency service

La infección del tracto urinario (ITU) es una patología frecuente en pediatría. Su diagnóstico ytratamiento precoz son fundamentales. Para un adecuado tratamiento, es importante conocer la sensibilidadantimicrobiana local. Objetivo: Identificar los agentes etiológicos más frecuentes y su sensibilidad antimicrobiana en urocultivos confirmatorios de ITU, solicitados en Servicio de Urgencia de Pediatría (SUP) del Hospital San Martin de Quillota (HSMQ). Materiales y métodos: Se analizaron todos los urocultivos solicitados desde el SUP del HSMQ entre enero 2013 – julio 2014. Se efectuó análisis por sexo y grupos etarios. La etiología y susceptibilidad microbiana se analizó con la técnica de difusión en agar. Resultados: Se analizaron 298 urocultivos, de los cuales el 80,5 por ciento correspondieron a mujeres. La bacteria encontrada más frecuente, en un 87,4 por ciento fue la Escherichia coli. La sensibilidad antibiótica de E.coli para ampicilina, cefalotina, cefixime, ciprofloxacino, ceftriaxona, gentamicina, nitrofurantoina y cotrimoxazol, correspondieron a un 23,3 por ciento; 32,8 por ciento; 96,6 por ciento; 92,7 por ciento; 97,7 por ciento; 94,5 por ciento; 99,6 por ciento; y 71,9 por ciento, respectivamente. Conclusión: El agente etiológico más frecuente en urocultivos confirmatorios solicitados en el SUP del HSMQ fue E. coli. Respecto a su sensibilidad antimicrobiana demostró una alta resistencia y sensibilidad intermedia a cefalosporinas de primera generación y una alta sensibilidad a cefalosporinas de tercera generación, nitrofurantoína, gentamicina y fluoroquinolonas...

Urinary tract infection (UTI) is a common pediatric disease. Early diagnosis and treatment are essential. For proper treatment, it is important to know the local antimicrobial susceptibility. Objective: Identify the most common etiologic agents and their antimicrobial susceptibility in urine cultures in Pediatrics Emergency Service (PES) of San Martin Hospital, Quillota. Summary of work: All the urine cultures requested from the PES between January 2013 and July 2014 were analyzed by sex and age groups. The etiology and microbial susceptibility was analyzed with the agar diffusion technique. Summary of Results: 298 urine cultures were analyzed, 80.5 percent were women. The most common bacteria found was Escherichia coli with 87.4 percent.The antimicrobial susceptibility of E.coli to ampicillin, cephalothin, cefixime, ciprofloxacin, ceftriaxone, gentamicin, cotrimoxazole and nitrofurantoin were 23.3 percent; 32.8 percent; 96.6 percent; 92.7 percent; 97.7 percent; 94.5 percent; 99.6 percent; and 71.9 percent, respectively. Conclusion: The most common etiologic agent in urine cultures requested in PES was E. coli. The antimicrobial susceptibility showed a high resistance and intermediate susceptibility to first generation cephalosporins and high susceptibility to thirdgeneration cephalosporins, nitrofurantoin, gentamicin andfluoroquinolones...

Proteus mirabilis biofilm - Qualitative and quantitative colorimetric methods-based evaluation

Proteus mirabilis strains ability to form biofilm is a current topic of a number of research worldwide. In this study the biofilm formation of P. mirabilis strains derived from urine of the catheterized and non-catheterized patients has been investigated. A total number of 39 P. mirabilis strains isolated from the urine samples of the patients of dr Antoni Jurasz University Hospital No. 1 in Bydgoszcz clinics between 2011 and 2012 was used. Biofilm formation was evaluated using two independent quantitative and qualitative methods with TTC (2,3,5-triphenyl-tetrazolium chloride) and CV (crystal violet) application. The obtained results confirmed biofilm formation by all the examined strains, except quantitative method with TTC, in which 7.7% of the strains did not have this ability. It was shown that P. mirabilis rods have the ability to form biofilm on the surfaces of both biomaterials applied, polystyrene and polyvinyl chloride (Nelaton catheters). The differences in ability to form biofilm observed between P. mirabilis strains derived from the urine of the catheterized and non-catheterized patients were not statistically significant.

Evaluación inmediata y a distancia de tres técnicas de sellado canalicular en dientes apicectomizados: experiencia en conductos de corte transversal achatado / Immediate and long-term evaluation of three root canal filling techniques in apicectomized teeth: an experience in flat cross-cut canals

Con el propósito de estudiar in vitro la capacidad de sellado en sentido corono-apical de tres técnicas de obturación canalicular (condensación lateral con conos de gutapercha + sellador de Grossman, cono único de gutapercha + sellador de Grossman y cono único de gutapercha + cemento de ionómero vítreo), en dientes apicectomizados de conductos de corte transversal achatado, se utilizó un método bacteriológico que permitió comprobar el grado de permeabilidad de bacterias conocidas (Proteus mirabilis y Streptococcus salivarius) a través de las obturaciones realizadas. Los resultados permitieron establecer que ninguna de las técnicas estudiadas resultó totalmente efectiva, tanto a la valoración inmediata como a distancia, apreciándose una marcada tendencia al aumento de la permeabilidad a la microfiltración bacteriana en las muestras conservadas (p<0,02). Resulta evidente, según esta experiencia, que la anatomía del conducto radicular condiciona la calidad de la obturación en aquellos dientes que deben ser apicectomizados

Perfil etiológico y susceptibilidad antimicrobiana del primer episodio de infección urinaria febril / Etiologic and antibiotic susceptibility profile of the first episode of febrile urinary tract infection

Urinary tract infection (UTI) is a common infection in childhood; its diagnosis involves performing a urine culture. Aim: To describe the etiology and bacterial susceptibility of the first episode of UTI in children presenting with fever to the emergency room. Patients and Methods : One hundred and five children (2 months -5 years old) seen at the Hospital Dr. Sotero del Rio in Santiago, between November 2009 and November 2010 were evaluated. A urine specimen was obtained by transurethral catheterization. Urine was cultured and microorganisms were identified and tested for antimicrobial susceptibility. Results: 76.2% (80) of patients were women and 80% (84) were under 18 months. Urine sediment was abnormal in 82.5%. The most frequently isolated microorganism was Escherichia coli (96.1%) showing high susceptibility to aminoglycosides (near 100%), third generation cephalosporins, ciprofloxacin and nitrofurantoin; and low susceptibility to cephalothin (69%) and trimethoprim/sulfamethoxazole (66%). We found one ESBL-producing strain. Conclusion: The most common uropathogen was E. coli with good in vitro susceptibility to aminoglycosides and third generation cephalosporins, which are the recommended initial empirical therapy. E. coli ESBL-producing strains appear as emerging pathogens in community acquired UTIs in children.

La infección del tracto urinario (ITU) es muy frecuente en la niñez y su diagnóstico implica la realización de urocultivo. Objetivo: Describir la etiología y susceptibilidad bacteriana del primer episodio de ITU en niños que consultaron por fiebre en una unidad de emergencia. PacientesyMétodos: Se evaluaron 105 niños (2 meses -5 años) consultantes en la Unidad de Emergencia Infantil del Hospital Sótero del Río del área sur-oriente de Santiago entre noviembre de 2009 y noviembre de 2010, con muestra de orina tomada por cateterismo trans-uretral para sedimento de orina, urocultivo y antibiograma. Resultados: El 76,2% (80) de los pacientes fueron mujeres y 80% (84) tenía menos de 18 meses. El sedimento de orina resultó alterado en 82,5%. El microorganismo aislado con mayor frecuencia fue Escherichia coli (96,1%) que mostró buena susceptibilidad in vitro (cercana a 100%) para aminoglucósidos, cefalosporinas de tercera generación, quinolonas y nitrofurantoína, y baja susceptibilidad para cefalotina (69%) y cotrimoxazol (66%). Una cepa era productora de β-lactamasa de expectro extendido (bLEE). Conclusión: El uropatógeno más frecuente fue E. coli que demostró buena susceptibilidad in vitro a aminoglucósidos y cefalosporinas de tercera generación, antimicrobianos parenterales recomendados como tratamiento empírico inicial para este grupo de pacientes. Las cepas de E. coli productoras de bLEE aparecen como patógenos emergentes en las ITUs adquiridas por niños en la comunidad.

Resistencia a cefalosporinas de espectro extendido en enterobacterias sin AmpC inducible: Evaluación de los nuevos puntos de corte / Resistance to extended-spectrum cephalosporins in non-inducible AmpC enterobacteria: Evaluation of the new MIC breakpoints

Los objetivos de este estudio fueron determinar la actividad in vitro de las cefalosporinas de espectro extendido frente a aislamientos clínicos de enterobacterias sin AmpC inducible y evaluar la utilidad de las normativas propuestas por el CLSI 2009 y de los puntos de corte recomendados por el CLSI 2010 y el EUCAST 2010. El análisis incluye la caracterización feno y genotípica de los mecanismos de resistencia. En todos los aislamientos se realizó un antibiograma semicuantitativo y se determinó la CIM por dilución en agar. Asimismo, se realizó la detección fenotípica de p-lactamasas de espectro extendido (BLEE), de AmpC plasmídica (AmpCp) y de carbapenemasas de tipo KPC. En los aislamientos que fueron resistentes a las cefalosporinas de espectro extendido (CEE) se evaluó, mediante PCR múltiple para b/aSHV y b/aCTX-M y PCR con cebadores específicos, el tipo de p-lactamasa pre-valente y la presencia de KPC. Se recuperaron de pacientes 169 aislamientos resistentes a CEE: 95 de K/ebsie//a pneumoniae, 55 de Escherichia co/i y 19 de Proteus mirabi/is. La resistencia a CEE se verificó en el 56,2 %; 32,6 % y 11,2 % de estos conjuntos de aislamientos, respectivamente. Se detectó el fenotipo BLEE en 152 aislamientos (90 %), el fenotipo AmpCp en 12 (7 %) y el KPC en 5 (3 %). Las recomendaciones del CLSI 2009 y los puntos de corte del CLSI 2010 y del EUCAST 2010 para la ceftriaxona permitieron detectar eficientemente las BLEE, mientras que para la ceftacidima, con los puntos de corte del CLSI 2010 solo se detectó el 55 % de las BLEE. Esta discrepancia en los porcentajes de resistencia a ceftriaxona y a ceftacidima se relaciona con la presencia de CTX-M en nuestro medio. Los nuevos puntos de corte detectaron con mayor eficiencia las enzimas de tipo AmpCp.

The aims of this study were to evaluate the in vitro activity of extended-spectrum cephalosporins (ESC) in non-inducible AmpC enterobacteria throµgh phenotypic and genotypic characterization of the mechanisms of resistance (ESBL, plasmid-mediated AmpC and KPC) and to evaluate the interpretation criteria proposed by the existing recommendations and the new breakpoints established by the CLSI and the EUCAST. Susceptibility tests and PCR multiplex for b/aSHV and b/aCTX-M and amplification using specific primers was performed. One hundred sixty nine resistant isolates: K/ebsie//a pneumoniae (95), Escherichia co/i (55), and Proteus mirabi/is (19) were recovered. ESC resistance was 56.2 %, 32.6%, and 11.2 %, respectively. ESBL was detected in 152 (90 %) isolates, plasmid-mediated AmpC in 12 (7 %) and KPC in 5 (3 %). The CLSI 2009 recommendations and the breakpoints sµggested by the CLSI 2010 and the EUCAST for ceftriaxone were efficacious to detect ESBL, whereas the different breakpoints for ceftazidime presented discrepancies. The CLSI 2010 breakpoints only detected 55 % of the ESBL-producing isolates due to the endemic presence of CTX-M ESBLs in our country. Regarding the plasmid-mediated AmpC producers, the recommendations of the CLSI 2010 and the EUCAST 2010 proved to be more efficient than the old ones.

Antimicrobial activities against biofilm formed by Proteus mirabilis isolates from wound and urinary tract infections.

Background: Bacterial species are capable of living as biofilm and/or planktonic forms. There is increasing evidence for the role of bacterial biofilm in various wound and urinary tract infections (UTIs). The aim of the present study was to evaluate the ability of the bacteria, isolated from urinary tract infections (UTIs) and wound infections, to form biofilm and correlate the role of biofilm with their antimicrobial resistance. Materials and Methods: All the isolated bacteria were screened for their ability to form biofilm using the microtitre plate method. Results: Wound isolates of Staphylococcus aureus and Enterobacter sp. had more biofilm forming capacity than the UTI isolates. Proteus mirabilis isolates were among the strongest biofilm forming bacteria and were chosen for antimicrobial study. In sub-MIC concentrations of antimicrobial agents used, ciprofloxacin was found to be the most effective in decreasing biofilm formation. On the other hand, ceftriaxone and ciprofloxacin were effective in partial removal of preformed biofilm biomass. Conclusion: Ciprofloxacin was more effective in killing bacterial cells especially at high antimicrobial concentrations that could be reached in urine levels and can be used in impregenating catheters.

Isolation and purification of complex II from proteus mirabilis strain ATCC 29245

A respiratory complex was isolated from plasma membrane of pathogenic Proteus mirabilis strain ATCC 29245. It was identified as complex II consisting of succinate:quinone oxidoreductase (EC 1.3.5.1) containing single heme b. The complex II was purified by ion-exchange chromatography and gel filtration. The molecular weight of purified complex was 116.5 kDa and it was composed of three subunits with molecular weights of 19 kDa, 29 kDa and 68.5 kDa. The complex II contained 9.5 nmoles of cytochrome b per mg protein. Heme staining indicated that the 19 kDa subunit was cytochrome b. Its reduced form showed absorptions peaks at 557.0, 524.8 and 424.4 nm. The á-band was shifted from 557.0 nm to 556.8 nm in pyridine ferrohemochrome spectrum. The succinate: quinone oxidoreductase activity was found to be high in this microorganism.

Prevalência de infecções hospitalares em unidade de terapia intensiva / Prevalence of nosocomial infection in intensive care unit

JUSTIFICATIVA E OBJETIVOS: A infecção hospitalar (IH) representa uma condição grave que influencia na morbimortalidade dos pacientes que permanecem internados. Em unidade de terapia intensiva (UTI), os pacientes encontram-se acamados por tempo prolongado, imunodeprimidos, com doenças graves que necessitam de monitoramento invasivo e uso de antibióticos de largo espectro, tornando-os mais suscetíveis às IH. O objetivo deste estudo foi avaliar a prevalência e o perfil microbiológico das IH na UTI, bem como a evolução dos pacientes notificados.MÉTODO: O estudo foi realizado no Hospital Pró-Clínicas no período de fevereiro a dezembro de 2008. Os casos de IH ocorridos foram notificados através da Ficha de Notificação de Infecção Hospitalar e os respectivos dados foram analisados no programa Doctor Clean versão 3.0.3.RESULTADOS: No período do estudo foram notificados 26 casos de IH. Sua prevalência foi no sexo masculino (57,69%), entre a 7ª e 8ª décadas, sendo o trato respiratório o local mais acometido (44,19%) e o micro-organismo mais isolado foi o Proteus mirabilis (22,22%).CONCLUSÃO: A partir dos resultados obtidos pode-se traçar um perfil microbiológico próprio da UTI, sendo possível programar uma terapêutica empírica mais eficaz e direcionada, reduzindo os custos hospitalares, o tempo de internação dos pacientes e o surgimento de micro-organismos multirresistentes.(AU)

BACKGROUND AND OBJECTIVES: The nosocomial infection (NI) is a serious condition that affects the mortality of patients who remain hospitalized. In an Intensive Care Unit (ICU) patients are bedridden for long periods, compromised, with serious illnesses that require invasive monitoring and use of broad spectrum antibiotics, making them more susceptible to NI's. The study aims to assess the prevalence and microbiological profile of NI's in the ICU and the evolution of the patients reported.METHOD: The study was performed at Hospital Pró-Clínicas from February to December of 2008. The cases of IH occurred were reported through the Notification Form Hospital Infection and the data were analyzed with the Doctor Clean program version 3.0.3.RESULTS: Throughout the study period were reported 26 cases of IH. Its prevalence was among males (57.69%), between the 7th and 8th decades, the respiratory tract was the most commonly affected (44.19%) and the most isolated microorganism was Proteus mirabilis (22.22%).CONCLUSION: From the results obtained one can draw a microbiological profile of the ICU itself, it is possible to implement an empirical therapy more accurately and efficiently, reducing hospital costs, length of hospital patients and the emergence of resistant microorganisms.(AU)

Resistance to imipenem in clinical isolates of kiebsiella pneumoniae and proteus mirabilis

Six Klebsiella pneumoniae and seven Proteus mirabilis clinical isolates were multiple drug resistant producing beta-lactamases. Out of the thirteen isolates, eight were resistant to third generation cephalosporin, cefotaxime and one was of intermediate resistance. Similarly, five isolates were resistant to fourth generation cephalosporin, cefepime with another five of intermediate resistance. However, isolates showed high alarming resistance pattern against imipenem and meropenem antibiotics. A representative imipenem resistant isolate from both strains were picked out for the detection of 40 kDa outer membrane protein and plasmid profile

Comparison of PCR-based molecular markers for the characterization of Proteus mirabilis clinical isolates

Proteus mirabilis is one of the most important pathogens associated with complicated urinary tract infections (acute pyelonephritis, bladder infections, kidney stones) and bacteremia, affecting patients with anatomical abnormalities, immunodeficiency, and long-term urinary catheterization. For epidemiological purposes, various molecular typing methods, such as pulse-field gel electrophoresis (PFGE) or ribotyping, have been developed for this pathogen. However, these methods are labor intensive and time-consuming. We evaluated the discriminatory power of several PCR-based fingerprinting methods (RAPD, ISSR, ERIC-PCR, BOX-PCR and rep-PCR) for P. mirabilis clinical isolates. Typing patterns and clustering analysis indicated that RAPD, BOX-PCR and ERIC-PCR differentiated P. mirabilis strains from Escherichia coli, Hafnia alvei, and Morganella morganii. With the exception of rep-PCR, the methods gave medium to high discriminatory efficiency in P. mirabilis. In general, the results obtained with RAPD, BOX-PCR and ERIC-PCR were in good agreement. We concluded that a combination of ERIC-PCR and BOX-PCR results is a rapid and reliable alternative for discrimination among P. mirabilis clinical isolates, contributing to epidemiological studies.

Occurrence of Proteus mirabilis associated with two species of venezuelan oysters

The fecal contamination of raw seafood by indicators and opportunistic pathogenic microorganisms represents a public health concern. The objective of this study was to investigate the presence of enteric bacteria colonizing oysters collected from a Venezuelan touristic area. Oyster samples were collected at the northwestern coast of Venezuela and local salinity, pH, temperature, and dissolved oxygen of seawater were recorded. Total and fecal coliforms were measured for the assessment of the microbiological quality of water and oysters, using the Multiple Tube Fermentation technique. Analyses were made using cultures and 16S rRNA gene sequencing. Diverse enrichment and selective culture methods were used to isolate enteric bacteria. We obtained pure cultures of Gram-negative straight rods with fimbriae from Isognomon alatus and Crassostrea rhizophorae. Our results show that P. mirabilis was predominant under our culture conditions. We confirmed the identity of the cultures by biochemical tests, 16S rRNA gene sequencing, and data analysis. Other enterobacteria such as Escherichia coli, Morganella morganii and Klebsiella pneumoniae were also isolated from seawater and oysters. The presence of pathogenic bacteria in oysters could have serious epidemiological implications and a potential human health risk associated with consumption of raw seafood.

A contaminação fecal de frutos do mar crus por microrganismos oportunistas patogênicos representa problema de saúde pública. O objetivo deste estudo é investigar a presença de bactérias entéricas que colonizam ostras coletadas em área turística da Venezuela. Amostras de ostras foram coletadas na costa noroeste da Venezuela e foram registrados a salinidade local, pH, temperatura e o oxigênio dissolvido na água do mar. O total de coliformes fecais foi medido para a avaliação da qualidade microbiológica da água e das ostras, usando a técnica de fermentação em tubos múltiplos. Análises foram feitas usando culturas e seqüência do gene 16S rRNA. Enriquecimento diversificado e métodos de cultura seletivos foram usados para isolar a bactéria entérica. Obtivemos culturas puras de bastões retos Gram negativos com fímbrias de Isognomon alatus e Crassostrea rhizophorae. Nossos resultados mostram que P. mirabilis foi predominante nas nossas condições de cultura. Confirmamos a identidade das culturas por testes bioquímicos, seqüência do gene 16rRNA e a análise de dados. Outras enterobactérias como Escherichia coli, Morganella morganii e Klebsiella pneumoniae foram também isoladas da água do mar e ostras. A presença de bactérias patogênicas em ostras podem ter implicações epidemiológicas e potencial risco para a saúde humana quando do consumo de frutos do mar crus.

Growth, swarming and production of halo-zone of different proteus mirabilis strains isolated from Jordanian clinical specimens

The growth, swarming and production of halo-zone by six different strains of P. mirabilis were examined on different selective media. Inability of strains to grow on different selective medium commonly showed at 25°C. The swarming did not observe on Baired-Parker stable base agar and cetrimide agar medium at both used temperatures [25 and 37°C]; whereas no swarming observed on desoxycholate citrate lactose agar medium at 25°C and on violet red bile agar medium at 37°C. Both strains [PM4 and PM5] were able to produce hydrogen sulfide [H 2S] at both used temperatures; in contrast, the other two strains [PM2 and PM3] were H 2S negative. But PM1 and PM6 were H 2S positive at 37°C and negative at 25°C. Several compounds inhibit the motility of swarmer cells by disturbing the structural integrity, the activity of flagella or by blocking their ability to move. Those compounds may also inhibit swarming but without affecting growth

Microbiota characterization of the catfish (Cathorops agassizii and Genidens genidens) sting venom

This work aimed to study the bacterial contamination of the catfishes stings Genidens genidens (Valenciennes, 1839); and Cathorops agassizii (Agassiz, 1829) found in the estuary-bay complex of Santos and São Vicente (São Paulo State). Fish samples for bacteriological analyses were obtained and constituted of a group of 50 specimens, being 25 of Cathorops agassizii and 25 of Genidens genidens,. The bacteriological analyses showed that there was contamination of the stings by 13 different strains of Enterobacteriaceae with Klebsiella pneumoniae (26,80%) as the most frequent bacteria and lower percentual frequencies for Enterobacter sp and Escherichia coli (16,27%) and Serratia marcescens, Serratia sp. and Proteus mirabilis (1,16%). Gram positive bacteria, as well fungi species were not detected in the samples. In basis of the Gram negative species characterized , is possible to consider the bacterial strains are representative of the environmental public health conditions, as well as, accidents with these fish stings are able to develop significative acute secondary infections in humans.

Este trabalho teve por objetivo o estudo da contaminação bacteriana do veneno do ferrão dos bagres Genidens genidens (Valenciennes, 1839); e Cathorops agassizji (Agassiz, 1829) encontrados no Complexo Baia-Estuário de Santos e de São Vicente (Estado de São Paulo). Foram obtidas amostras dos peixes para análises bacteriológicas que constituíam de um grupo de 50 espécimes sendo, 25 Cathorops agassizii e 25 de Genidens genidens. As análises bacteriológicas mostraram que havia contaminação nos ferrões por 13 diferentes linhagens de Enterobacteriaceae, sendo a Klebsiella pneumoniae (26,80%) a bactéria mais freqüente enquanto que as Enterobacter sp e Escherichia coli (16,27%), Serratia marcescens, Serratia sp e Proteus mirabilis (1,16%) apresentaram os mais baixos percentuais de contaminação. Nas amostras que apresentaram Bactérias Gram positivas não foram detectadas espécies de fungos. Enquanto que nas amostras que apresentaram bactérias Gram negativas, foi possível considerar alta contaminação bacteriana representando periculosidade em relação aos aspectos ambientais voltados á saúde pública. Destaca-se ainda que acidentes ocorridos por ferimentos causados em função do ferrão do bagre podem desenvolver significativas infecções secundárias agudas em humanos.

Avaliaçäo da microbiota bacteriana nasal de hansenianos / Evaluation of the nasal bacterial microbiota of bearers of Hansen's Disease

Este estudo teve como objetivo comparar a microbiota bacteriana nasal de portadores de hanseníase lepromatosa, tratados sistematicamente com Rifampicina, Clofazimina e Sulfa, com um grupo de indivíduos sadios sem o uso de antibióticos. Foram coletadas amostras de mucosa nasal de 57 hansenianos, internos do Hospital de Dermatologia Sanitária de Curitiba, e de 40 indivíduos com mucosa normal. Na coleta, as mucosas nasais foram avaliadas quanto à presença de lesöes, e as amostras semeadas em meios para pesquisa de Saureus e enterobactérias. Nos hansenianos observou-se S. aureus em 100 por cento; Proteus mirabilis em 91 por cento; E. coli, Enterobacter aerogenes, Klebsiella pneumonia e Pseudomonas aeruginosa em 24 por cento, resistentes aos antibióticos testados no antibiograma. Nos indivíduos sadios isolou-se S. aureus em 100 por cento e P. aeruginosa em 0,5 por cento, sensíveis aos antibióticos testados, e näo foram isoladas amostras do gênero Proteus. Conclui-se que nos portadores de hanseníase estudados, a microbiota nasal encontra-se alterada e resistente devido ao emprego sistemático dos antibióticos do esquema tríplice

Paciente Quirúrgico Séptico en Terapia Intensiva / Surgical septic patient in Intensive Care Unit

Se realizó un estudio anual de 121 pacientes quirúrgicos sépticos ingresados en Terapia Intensiva en el Hospital Provincial Clinicoquirúrgico Docente "Dr. Gustavo Aldereguía Lima" y se aplicaron métodos computadorizados para el procesamiento de datos y aplicación de pruebas de significación estadística. La edad media de la serie fue de 40,4 para vivos y 47,35 para fallecidos; la mayor letalidad correspondió a pancreatitis hemorrágica (80) y cirugía gastroduodenal (45,5). En el 41.32 por ciento el diagnóstico se basó en el examen físico y ultrasonido abdominal. Existió un incremento franco de evolución desfavorable al aumentar el número de intervenciones quirúrgicas. Los gérmenes más frecuentes fueron Klebsiella psneumoniae, E. coli, Pseudomona aeruginosa y Proteus mirabilis. Los anti-bióticos más usados fueron metronidazol, penicilinas y aminoglucósidos. Se destaca el 8,2 de incidencia para fallo multiórgano (FMO) con 100 por ciento de letalidad y un predominio de la evolución favorable en 84 enfermeos y 37 que fallecieron

Factores de urovirulencia bacteriana: asociación con recurrencias y anomalías anatómicas y funcionales en niños con infección del tracto urinario / Urinary bacterial virulence factors: association with recurrence of anatomical and functional abnormalities and urinary tract infection in children

A prospective sample of children was incorporated into a followup protocol after their first episode of bacteriologically-demonstrated urinary tract infection. In all patients an abdominal ultrasound examination and a mictional urethrocystography were done and the presence of fiambriae was studied in isolated strains of Escherichia coli. Two hundred fifteen cases had an adequate adherence to the study protocol, 190 caused by E coli. Fiambristed E coli strains were isolated with greater frequency from children with pyelonephritis than from those with a low urinary tract infection (50 and 28 percent respectively). The absence of fiambriae in E coli strains was associated with a higher risk of recurrent infections (odds ratio=3, confidence intervals=1.1-10.2). These data are consistent with foreign reports and support the need to study adhesins in E coli strains isolated from children with urinary tract infections