Frequência e resistência de uroculturas provenientes de pacientes internados na unidade de terapia intensiva do hospital municipal de Santarém-PA / Frequency and resistance of urocultures from patients interned in the Santarém-PA municipal hospital

Objetivo: Avaliar a frequência e a resistência dos principais microrganismos encontrados na urina de pacientes internados no hospital municipal de Santarém, Pará, nos meses de janeiro a junho de 2018. Métodos: Apresentando um estudo documental retrospectivo, descritivo, quantitativo, contrapondo as revisões bibliográficas de artigos bem esclarecidos e sucintos a respeito do tema abordado, indexadas em bases de pesquisa de artigos científicos e bibliotecas virtuais SciELO, PubMed, Lilacs e Google Acadêmico. Resultados: Dos 153 pacientes analisados, 59,6% eram mulheres, 40,4% eram homens e todos utilizavam cateter. Em relação aos uropatógenos, os mais frequentes foram os Gram-positivos: Escherichia coli com 53,8 %, Proteus mirabilis com 13,5%, juntamente com Klebsiella pneumoniae com 9,6%, Pseudomonas aeruginosa com 9,6% e Staphylococcus epidermidis com 5,8%. Foi encontrada uma prevalência de Escherichia coli de acordo com a faixa etária. Ampicilina e ciprofloxacino apresentaram respectivamente menor e maior poder inibitório contra enterobactérias. Porém, Klebsiella pneumoniae apresentou 100% de resistência às fluoquinolonas de 1ª e 2ª geração, além de apresentar padrão de resistência mais amplo. As taxas de resistência às cefalosporinas sugerem produção ESBL. Conclusão: O estudo demonstrou que o perfil dos pacientes acometidos com ITU nas UTI's era do sexo feminino (59,6%) e a bactéria mais frequente foi a Escherichia coli (53,8%). A faixa etária mais acometida foi acima de 60 anos, com 53,8% do total. Esses dados corroboram os encontrados na literatura em geral.

Objective: To evaluate the frequency and resistance of major microorganisms found in the urine of patients admitted to the municipal hospital of Santarém Pará, from January to June 2018. Methods: Presenting a retrospective, descriptive and quantitative documentary study, contrasting the bibliographic reviews of well-informed and succinct articles about the theme, indexed in scientific articles and virtual libraries research databases SciELO, PubMed, LILACS and Google Scholar. Results: Of the 153 patients analyzed, 59.6% were women and 40.4% were men, all using catheters. Gram-positive uropathogens were Escherichia coli 53.8%, Proteus mirabilis 13.5%, Klebsiella pneumoniae 9.6%, Pseudomonas aeruginosa 9.6% and Gram-positive Staphylococcus epidermidis with 5.8%. A prevalence of Escherichia coli was found according to age group. Ampicillin and ciprofloxacin showed respectively lower and higher inhibitory power against enterobacteria. However, Klebsiella pneumoniae presented 100% resistance to 1st and 2nd generation fluoquinolones, besides presenting a broader resistance pattern. Cephalosporin resistance rates suggest ESBL production. Conclusion: The study showed that the profile of patients with UTI in the ICU is female (59.6%) and the most common bacterium was Escherichia coli (53.8%). The most affected age group was over 60 years old, with 53.8% of the total. These data corroborate those found in the general literature.

In vitro treatment of lipopolysaccharide increases invasion of Pasteurella multocida serotype B:2 into bovine aortic endothelial cells

Pasteurella multocida serotype B:2 causes hemorrhagic septicemia in cattle and buffalo. The invasion mechanism of the bacterium when invading the bloodstream is unclear. This study aimed to characterize the effects of immunomodulatory molecules, namely dexamethasone and lipopolysaccharide, on the invasion efficiency of P. multocida serotype B:2 toward bovine aortic endothelial cells (BAECs) and the involvement of actin microfilaments in the invasion mechanism. The results imply that treatment of BAECs with lipopolysaccharide at 100 ng/mL for 24 h significantly increases the intracellular bacteria number per cell (p < 0.01) compared with those in untreated and dexamethasone-treated cells. The lipopolysaccharide-treated cells showed a significant decrease in F-actin expression and an increase in G-actin expression (p < 0.001), indicating actin depolymerization of BAECs. However, no significant differences were detected in the invasion efficiency and actin filament reorganization between the dexamethasone-treated and untreated cells. Transmission electron microscopy showed that P. multocida B:2 resided in a vacuolar compartment of dexamethasone-treated and untreated cells, whereas the bacteria resided in cellular membrane of lipopolysaccharide-treated cells. The results suggest that lipopolysaccharide destabilizes the actin filaments of BAECs, which could facilitate the invasion of P. multocida B:2 into BAECs.

Septicemia hemorrágica y empiema pleural por Pasteurella canis / Pasteurella canis hemorragic sepsis and empyema

We report the case of a 56-year-old female patient, with a three-day history of hematemesis, melena, abdominal wall hematoma and epistaxis associated with thrombocytopenia and anemia. Idiopathic thrombocytopenic purpura was diagnosed and she was treated with dexamethasone for four days. The patient developed acute respiratory failure with signs of systemic inflammatory response. Blood and pleural fluid cultures grew Pasteurella canis. This is the first case, to our knowledge, of P. canis empyema associated with hemorrhagic septicemia without epidemiological background and the third case of septicemia caused by P. canis reported in the literature.

Comunicamos el caso de una mujer de 56 años de edad, con un cuadro clínico de tres días de evolución caracterizado por hematemesis, melena, hematoma en la pared abdominal y epistaxis, asociado a trombocitopenia y anemia. Con un probable diagnóstico de un púrpura trombocitopénico idiopático, se trató con dexametasona por cuatro días. Evolucionó con una insuficiencia respiratoria aguda con signos de respuesta inflamatoria sistémica, por un empiema pleural izquierdo con aislamiento de Pasteurella canis en hemocultivos y líquido pleural. Este es el primer caso, según nuestro conocimiento, de un empiema por P. canis asociado a una septicemia hemorrágica, sin antecedentes epidemiológicos; y tercero de una sepsis por P. canis publicado en el mundo.

Molecular heterogeneity of plpE gene in Indian isolates of Pasteurella multocida and expression of recombinant PlpE in vaccine strain of P. multocida serotype B: 2

Outer membrane proteins of Pasteurella (P.) multocida have been known to be protective immunogens. Pasteurella lipoprotein E (PlpE) has been reported to be an important cross reactive outer membrane protein in P. multocida. The gene encoding the PlpE of P. multocida serotypes A: 3, B: 2 and D: 1 was amplified from the genomic DNA. The amplified products were cloned and the nucleotide sequence was determined. Sequence analysis of the recombinant clones revealed a single open reading frame of 1,011 bp, 1,008 bp and 1,017 bp encoding a protein with a calculated molecular mass of 37.829 kDa, 37.389 kDa and 37.965 kDa for serotypes A: 3, B: 2 and D: 1 respectively. The comparison of the plpE sequence in different capsular types revealed a high degree (>90%) of homology. Furthermore, the plpE gene of Haemorhhagic septicaemia causing serotype (B: 2) was expressed in E. coli and recombinant PlpE was strongly immunostained by antiserum against whole cell antigen, indicating that the protein is expressed in vivo.

Distúrbios morfológicos em leucócitos de exemplar de kinguio (Carassius auratus auratus Linnaeus, 1758) com septicemia hemorrágica bacteriana: relato de caso / Morphologic disorders in leukocytes of goldfish sample (Carassius auratus auratus Linnaeus, 1758) with bacterial hemorrhagic septicemia: case report

O presente estudo teve por objetivo relatar um caso sobre as alterações morfológicas em leucócitos de kinguio comsepticemia hemorrágica bacteriana. Um exemplar foi atendido no Laboratório de Patologia de Organismos Aquáticos doCAUNESP, Unesp de Jaboticabal, apresentando apatia, natação errática, anorexia e discreta perda de equilíbrio, buscandoconstantemente a superfície da água. Através de análise visual da superfície corpórea, foram observadas áreas de hemorragiapetequial na base das nadadeiras peitoral, pélvica e caudal, além da órbita bucal, periocular e anal e efusão celomática. Naextensão sanguínea foram observadas a presença de monócitos ativados, hiperativados, e fagócitos mononuclearesrealizando eritrofagocitose e leucofagocitose, neutrófilos com basofilia citoplasmática e com vacuolização citoplasmática,além de imunócitos e leucócitos imaturos com anisocitose e anisocariose. As alterações morfológicas descritas no presenteestudo revelaram parte da patogenia e resposta orgânica de kinguio com septicemia hemorrágica bacteriana. Dessa forma,as análises qualitativas das células sanguíneas devem ser também utilizadas como ferramenta complementar aos estudosdo estado geral da saúde de peixes em cultivo.

The morphological changes in leukocytes of goldfish with bacterial hemorrhagic septicemia were reported. One sample was served at the Laboratory of Pathology of Aquatic Organisms of CAUNESP, Unesp in Jaboticabal. The fish showed lethargy, erratic swimming and without force, slight loss of balance, trying constantly to the water surface. In the body inspection, areas of petechial hemorrhage at the base of the pectoral fins, pelvic fins and caudal fin were observed, beyond the periocular and oral orbitand anal. Blood smears presented hiperactivated monocytes, performing erythrophagocytosis and leukophagocytosis, the cytoplasm of neutrophils presented basophilia and vacuolization, beyond immunocytes, immature leukocytes with anisocytosis and anisokaryosis. The morphological changes described in this study revealed part of the pathogenesis and organic response of Kinguio with bacterial hemorrhagic septicemia. Then, the qualitative analysis of blood cells should also be used as a complementary tool to study the general health status of fish farmed

Isolation and characterization of lactococcus garvieae from diseased rainbow trout [Oncorhynchus mykiss, Walbaum] cultured in Iran

A total of 200 moribund rainbow trout with clinical signs of a hyperacute haemorrhagic septicemia were collected from rainbow trout farms in Fars, Kohkiloyeh-Boyer Ahmad and Charmohal-Bakhtiari provinces in the south and southwest of Iran during summer 2002 to winter 2008 for detection of Lactococcus garvieae, the causative agent of lactococcosis. Fish kidney samples were cultured aseptically onto brain heart infusion agar plates and incubated at 25°C for 48 h. Using conventional biochemical tests, L. garvieae was detected from 32 fish [16% of total fish samples]. Additionally, isolates were confirmed as L. garvieae using a specific PCR assay based on 16S rDNA gene by producing a single band of 1107 bp. Partial analysis of 16S rDNA revealed 100% sequence similarity for all Iranian isolates and there was a close genetic relationship among these isolates and those previously reported from mullet in Taiwan [AF352166] and yellowtail in Japan [AB267897] based on GenBank data. Results of antibiogram tests on L. garvieae isolates showed a high susceptibility to erythromycin, enrofloxacin, chloramphenicol and clarithromycin. In pathogenicity tests, immersion of fish in a bacterial suspension of 6x10[5] colony forming unit/ml of L. garvieae in challenge experiments showed 60% mortality during 14 days post-infection. Experimentally, infected fish showed typical blackening of skin haemorrhages, exophthalmia and wide haemorrhages on viscera. The present study provides useful molecular and biochemical information for L. garvieae isolates in Iran compared with those from different hosts and geographic locations

Effects of gender and seasonal variation on the prevalence of bacterial septicemia among young children in Benin city, Nigeria

Aim: To determine the effects of gender and seasonal variations on the prevalence of bacterial septicaemia among children 5 years and younger; and to identify the bacterial agents responsible for septicaemia and their antibiotic susceptibility profiles. Methods: Blood was collected from 1;724 children (967 males and 757 females) aged 1 day to 5 years with clinical signs and symptoms of septicaemia. This study was carried out from 1 January to 31 December 2007 at the University of Benin Teaching Hospital; Benin City; Nigeria. The blood samples were processed to diagnose bacterial septicaemia. Bacterial isolates were identified and susceptibility test was performed using standard techniques. Results: An overall prevalence of 22.10of confirmed bacterial septicaemia was observed in this study. Generally; gender and seasonal variations did not significantly affect the prevalence of bacterial septicaemia; though females (50.57) during the dry season had significantly (p 0.001) higher prevalence than their male counterparts (19.91). Staphylococcus aureus was the predominant bacterial isolate causing septicaemia in both seasons; while Citrobacter freundii was the least frequent. Pseudomonas aeruginosa was not recovered during the dry season. Most isolates were susceptible to gentamicin and cefuroxime; but only 1.44of Staphylococcus aureus strains were susceptible to ceftriaxone. Conclusion: Bacterial septicaemia was observed in 22.1of children 5 years and younger with clinical signs and symptoms of septicaemia. Seasonal variation did not affect the prevalence. Effect of gender was only noticed in the dry season; where females had a higher prevalence than males. Gentamicin and cefuroxime were the most active antibacterial agents. Rational use of antibiotics is advocated

Pathogenicity and immunogenicity of native and mutant strains of Pasteurella multocida, the causative agents of haemorrhagic septicaemia

Haemorrhagic septicaemia [HS] is a fatal systemic disease of cattle and buffaloes. Some control is achieved with administration of alum-precipitated or oil-adjuvanted killed whole-cell vaccines injected subcutaneously. These vaccines, however, provide only short-term immunity and for effective use, they should be administered annually. We constructed an aroA attenuated derivative of a Pasteurella multocida serotype B:2 strain by allelic exchange of the native aroA sequence with aroA sequences disrupted with a kanamycin resistance cassette. This strain was confirmed to be aroA mutant by PCR. The aroA derivative was highly attenuated for virulence in a mouse model of HS and rabbits. Mouse and rabbit challenge experiments showed that i.p. or i.m. vaccination of an aroA strain completely protected mice or rabbits against challenge with a high dose [>1000 LD[50]] of the parent strain

Childhood Septicaemia Due To Salmonella Species in Ibadan, Nigeria

A cross sectional study to assess the incidence and antibiotic sensitivity patterns of Salmonella isolates in septicaemic children who were presented at the children's emergency unit and children out-patient clinic, University College Hospital, Ibadan was undertaken. A total of 442 samples from children (6months and 11 years) with the history of fever were investigated, using blood culture method. The frequency of 151 bacteria isolated, were as follows: Staphylococcus aureus 50 (33.1%), Escherichia coli 29 (19.2%), Salmonella typhi 19 (12.6%), Staphylococcus albus 14(9.3%), Klebsiella species 12(7.9%), Pseudomonas aeruginosa 10(6.6%), Enterococcus faecalis 9(5.9%), Salmonella paratyphi 6(3.9%) and Haemophilus species 2(1.3%). Septicaemia due to Salmonella speciesshowed the highestamongchildren aged5-11years bracket (56%), followed by 1-5 years group (36%); while those within 0-1 year group showed the lowest frequency of (8%). Inthe antibiotic sensitivity patterns of Salmonella typhi and Salmonella paratyphi, only Ceftriaxone showed 100% sensitivity in-vitro.While Gentamicin, Ofloxacin,Cefrazidime; Augmentin, Pefloxacin, Chloramphenicol, Amoxycillin, Cotrimoxazole showed varied sensitivity/resistance in descending order. These findings suggest an increasing resistance to the antibiotics commonly used for salmonellosis and the rate at which bacteria become resistant to antimicrobial agents is of public health concern. This calls for routine bacteriological culture and sensitivity test in the management of bacterial infections. Furthermore, the provision of adequate health care, wholesome water for drinking and domestic use by governments cannot be overemphasized

Comparative immunogenecity of foot and mouth disease virus antigens in FMD-haemorrhagic septicaemia combined vaccine and FMD vaccine alone in buffalo calves.

Humoral immune response was evaluated by monitoring the serum antibody titres and virus specific IgM titres against Foot and Mouth Disease (FMD) virus antigens in serum samples obtained from different groups of calves inoculated with combined vaccine or FMD vaccine alone, on 0, 7, 14, 21, 28, 42 and 56 days post-vaccination (DPV). The cellular immune response was monitored by MTT based lymphoproliferation in peripheral blood mononuclear cell cultures. Higher liquid phase blocking (LPB) ELISA antibody titres were observed in calves receiving combined vaccine as compared to calves immunized with FMD vaccine alone with the peak titres in both the groups obtained on 21 days post-vaccination. However, the virus specific IgM titres were significantly higher in group of calves inoculated with combined vaccine than FMD vaccine alone. The lymphoproliferative responses against FMDV types O, A22 and Asia 1 in the groups receiving combined vaccine and FMD vaccine alone started increasing gradually after day 14 and reached peak levels on 28 DPV followed by a gradual decline subsequently. The group receiving combined vaccine showed higher proliferative responses on in vitro stimulation with FMD virus type O, whereas, with FMD virus type Asia 1, the responses were significantly higher on 14 and 21 DPV as compared to the group immunized with FMD vaccine alone. However, in the group receiving combined vaccine, the responses on in vitro stimulation with FMD virus type A22 were significantly higher than FMD vaccine alone group on all DPV except on 42 DPV.

Neonatal Campylobacter coli hemorrhagic enteritis and bacteraemia

Um caso de campylobacteriose neonatal com enterite hemorrágica e bacteremia produzido por Campylobacter coli é apresentado. A mãe, proveniente de uma região rural, apresentou durante a gravidez, três episódios de diarréia autolimitada. A infeccão no recém nascido provavelmente foi adqüirida durante o parto. Os altos níveis séricos de immunoglobulinas específicas poderiam explicar a escassa sintomatologia, apesar da demorada prescricão do tratamento com gentamicina.

A Case of pasteurella multocida pleural empyema / 결핵

Pasteurella multocida, a Gram-negative coccobacillus, is part of the normal oral flora of many types of animals, including domestic dogs and cats. It is the etiologic agent of a variety of infectious diseases, such as hemorrhagic septicemia in cattle or fowl cholera in chiken. Although this is a primary pathogen in the animal world, infection due to Pasteurella multocida in man has been described with increasing frequency recently. The majority of individuals with pasteurella multocida pulmonary infection possess some underlying pulmonary diseases, most commonly bronchiectasis or COPD. With review of literature, We report a young man who developed the empyema caused by Pasteurella multocida.

Absceso hepático piogeno. A propósito un caso / Hepatic abces. report of a case

Los abscesos hepáticos se relacionan a 2 grupos diferentes: Bacterias Piogenas y Entomoeba Histolitica. Con diferentes manifestaciones clínicas y tratamiento. El absceso hepático tiene una frecuencia de 0, 36 por ciento de Necropsia y ocurre en 6t§ y 7mo. decenios, sin predilección de sexo o raza. Los reportes residentes indican que la colangitis secundaria a cálculos o carcinoma, Septicemia generalizada y apendicitis aguda perforada son las causas más frecuentes. El 80 por ciento de los cultivos son positivos a Scherichia Coli, Staphilococus Aureus, Streptococos Hemolitico, Proteus, Klepsiella Bacteriodes y Anaerobios, estos últimos son cada ves más frecuentes

Aislamiento de Aeromona hydrophila en trucha Arcoiris (Oncorhynchus mykiss) / Isolation of Aeromona hydrophila in rainbow trowt (Oncorhynchus mykiss). Case report

Se realizó un muestreo en una granja piscícola dedicada a la explotación de trucha Arcoiris (Oncorhynchus mykiss), ubicada en el Estado de México, México, en el cual hubo un brote de septicemia hemorrágica provocada por el agente etiológico Aeromona hydrophila. Los animales presentaban oscurecimeinto de la piel, exoftalmina unilateral y el patrón de comportamiento alterado, la morbilidad fue del 80 por ciento y la mortalidad del 51.2 por ciento. Se llevaron a cabo estudios de histopatología y se encontró lesiones en intestino anterior, con hiperplasia del epitelio de las vellosidades, En encéfalo (cerebro medio) hubo congestión leptomeningea moderada difusa y en ojo se apreciaron focos de trombosis y reacción inflamatoria constituida por monocitos en la región periesclerótica y epitelio corneal. Se realizó estudio bacteriológico a partir del hígado de truchas Arcoiris afectadas, de donde se aisló A. hydrophilia, corroborándose las lesiones y el cuadro clínico antes descritos con la presencia del agente

Dietary fat manipulation (Omega-3 vs Omega-6 fatty acids) on inmune function and septic survival in a model of consecutive hemorrhage / Manejo dietético de grasas (Omega-3 vs Omega-6 de ácidos grasos) en la función inmune y supervivencia septica en un modelo de hemorragia consecutiva

Following hemorrhagic shock, severe deragements of hemodynamic and inmune responses occur wich may lead to increased mortality and infectious complications. We utilized a murine model of hemorrhagic shock, and tested the effects of pre-feeding animals for 7 days with 3 different diets. Two consecutive acute hemorrhages were induced by cutting the tail under light anesthesia 30 min apart, with each bleeding depleting the animal of approximately 20// of the blood volume. At 24 hrs after hemorrhage, a period of maximal immunosuppresionand susceptibility to srpsis, animals underwent septic challenge, using cecal ligation. Pre-feeding the animals with a defined diet which contains high protein, arginine, nucleic acids, and structured lipids including fish oil (ImpactTM) improved survival after subsequent abdominal sepsis, compared to animals receiving standard rodent chow does not contain supplemental arginine, nucleic acids or structured lipids (TraumacalTM). Although special diets may improve survival in the face of subsequent septic challenge, the mechanisms involved are not clear, and factors other than immune simulation may account for this effect

Peste suína clássica: II. Estudo sobre um vírus amostra chinesa, adaptado ao cultivo celular (amostra Porto Alegre) / Classical swine fever: II. A study of a chinese strain adapted in tissue culture (Strain Porto Alegre)

Uma amostra genuína chinesa foi adaptada em cultura de células de linhagem de rim de coelho (RK13), através de passagens sucessivas e clonagem, na temperatura de 37§ C. Na décima passagem, após a clonagem, a semente foi liofilizada e estocada a - 70§ C. A partir dessa semente, entäo denominada da Cepa Porto Alegre (CPA), foram produzidas várias suspensöes víricas com as quais preparou-se uma vacina experimental. As características "in vitro" e "in vivo" da amostra CPA foram entäo estudadas. "In vitro", a amostra de vírus cresce regularmente em células RK13, demonstrada pelo teste e imunofluorescência direta com formaçäo de grandes placas de células com citoplasma fluorescente. Entretanto a amostra CPA näo cresceu em células PK15 nas primeiras 5 passagens. "In vivo" a amostra CPA näo provocou fluorescência em tecido de suínos vacinados, mas é hipertermizante para coelhos. O vírus liofilizado resistiu bem a 27§ C, durante 5 meses e por 12 meses na temperatura entre 15 e 36§ C. Reconstituído com o respectivo diluente e mantido a 25-26§ C, manteve título infeccioso estável por 24 horas e conferiu 100//de proteçäo em vacinas até 72 horas pós diluiçäo. Esta amostra näo mostrou virulência residual para suínos imunodeprimidos e é inócua para porcas gestantes, a partir de 40 dias da cobertura. Näo possui capacidade de difusäo de suíno para suíno, e näo foi possível recuperar o vírus de órgäos de suínos, após 42 dias de vacinaçäo. A amostra CPA só pode ser recuperada do suíno, através de inoculaçäo de macerado de baço em coelhos, por via endovenosa. Os suínos vacinados e desafiados 14 dias após foram 100//protegidos, näo havendo pique febril causado pelo vírus de desafio