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1.
São Paulo; s.n; s.n; 2022. 73 p. tab, graf.
Thesis in Portuguese | LILACS | ID: biblio-1392322

ABSTRACT

O perfil de resistência, que algumas das espécies do complexo Klebsiella pneumoniae podem expressar, representa uma grande ameaça à saúde humana, particularmente quando resistentes aos carbapenêmicos, que são amplamente utilizados no tratamento de infecções graves em pacientes hospitalizados. O principal mecanismo de resistência aos carbapenêmicos é a produção de carbapenemases, particularmente dos tipos KPC e NDM. Um dos compostos desenvolvidos para o tratamento de infecções causadas por cepas produtoras de KPC é a combinação ceftazidimaavibactam (CAZ-AVI), mas que não tem atividade inibitória sobre metalo-betalactamases, a exemplo das NDMs. Os objetivos deste trabalho foram determinar a frequência das espécies do complexo K. pneumoniae e da coprodução de KPC, avaliar a clonalidade dos isolados, a sensibilidade ao aztreonam-avibactam (ATM-AVI), o desempenho do disco de meropenem (MEM) com inibidores para detecção de coprodução de NDM e KPC e desenvolver um teste de triagem para prever a sensibilidade ao ATM-AVI. Um total de 113 isolados do complexo K. pneumoniae produtoras de NDM ou coprodutoras de NDM e KPC, provenientes da coleção de bactérias do Grupo Fleury, coletadas períodos pré e pós início do uso de CAZ-AVI no Brasil, foram utilizadas neste estudo. A identificação da espécie e a presença dos genes blaNDM e blaKPC foi confirmada por PCR multiplex. A clonalidade dos isolados foi avaliada por eletroforese em campos pulsados (PFGE) após clivagem com XbaI. A produção de carbapenemases foi confirmada utilizando-se o teste Blue Carba. O desempenho dos discos de meropenem e CAZ-AVI contendo um ou mais inibidores de carbapenemases foi comparado com o teste molecular. A pré-difusão combinada foi realizada pré-incubando-se o ágar não inoculado com disco de CAZ-AVI, e a seguir aplicando-se o inóculo bacteriano e um disco de ATM após remover o disco de CAZ-AVI. Após incubação, os halos foram aferidos e correlacionados com a concentração inibitória mínima para ATM-AVI. As CIMs para ATM e ATM-AVI foram determinadas segundo o EUCAST. A identificação das espécies por PCR evidenciou as seguintes frequências: K. pneumoniae 75,2% (n=85); K. quasipneumoniae 16,8% (n=19), e K. variicola 8% (n=9). Uma fração de 12,4% (n=14) dos isolados apresentaram os genes blaNDM e blaKPC e 87,6% (n=99) apenas blaNDM. A análise dos perfis de PFGE de K. pneumoniae evidenciou a presença de cinco grupos clonais predominantes. Isolados do principal grupo clonal Ap (n=15) foram detectados nas cidades de São Paulo e Porto Alegre durante todo o período analisado. O grupo clonal Lp foi detectado nas cidades de São Paulo e Recife em 2019. Os dois principais grupos clonais no período pré-CAZ-AVI continham maior número de isolados do que aqueles no período de uso do CAZ-AVI. Os perfis de PFGE de K. quasipneumoniae evidenciaram quatro grupos clonais predominantes, e presentes apenas no estado de São Paulo, com persistência do grupo clonal Aq desde 2017. Quanto à K. variicola, foram observados dois grupos clonais predominantes Av e Bv, o primeiro presente apenas em São Paulo desde 2018 e o segundo em Porto Alegre apenas em 2019. Calculando-se a diferença entre os diâmetros de halo do disco MEM contendo EDTA e ácido fenilborônico (AFB) e o maior dos halos obtidos para MEM com EDTA ou AFB, observou-se que todos os isolados com coexpressão de KPC e NDM apresentaram diferença ≥ 5 mm. Uma fração de 42,3% dos isolados positivos apenas para blaNDM apresentaram sensibilidade para ATM (CIM ≤ 4 mg/L). Todos os isolados testados apresentaram CIM para ATM-AVI ≤ 1/4 mg/L, sendo a CIM90 0,125/4 mg/l. No teste de pré-difusão combinada, o menor diâmetro de halo obtido foi de 23 mm. A espécie predominante na amostragem foi K. pneumoniae. A disseminação clonal, observada neste estudo, contrasta com a diversidade clonal descrita em outros locais do mundo para produtores de NDM, exceto Grécia e China. Considerando os pontos de corte atuais para ATM, é provável que haja resposta clínica adequada no uso de ATM-AVI no tratamento de infecções causadas por isolados produtores de NDM e coprodutores de KPC e NDM. Utilizando-se o valor de corte de ≤ 5 mm para a diferença entre halos de inibição, de MEM com AFB e EDTA e o segundo maior halo com inibidor, a sensibilidade foi de 100% e a especificidade foi de 96,1,0%. O método de pré-difusão com CAZ-AVI e ATM é um método simples e o diâmetro ≥ 23 mm tem excelente correlação com a CIM para ATM-AVI ≤ 1/4 mg/L


The resistance profile, which some species of the Klebsiella pneumoniae complex may express, represent a great threat to human health, particularly when resistant to carbapenems, which are widely used in the treatment of severe infections in hospitalized patients. The main mechanism of resistance to carbapenems is the production of carbapenemases, particularly KPCs and NDMs. One of the compounds developed for the treatment of infections caused by KPC-producing strains is the combination ceftazidime-avibactam (CAZ-AVI), but which has no inhibitory activity on metallobetalactamases, as is the case for NDMs. The objectives of this work were to determine the frequency of K. pneumoniae complex species and KPC co-production, evaluate the clonality of isolates, the susceptibility to aztreonam-avibactam (ATM-AVI), the performance of meropenem (MEM) disks with inhibitors for detecting NDM co-production and KPC and develop a screening test to predict sensitivity to ATM-AVI. A total of 113 NDM-producing or NDM and KPC co-producing K. pneumoniae complexes, from the Fleury Group's bacteria collection, collected in the pre- and post-starting periods of CAZ-AVI use in Brazil, were used in this study. Species identification and the presence of the blaNDM and blaKPC genes were confirmed by multiplex PCR. The clonality of the isolates was evaluated by pulsed field electrophoresis (PFGE) after cleavage with XbaI. Carbapenemase production was confirmed using the Blue Carba test. The performance of MEM and CAZ-AVI disks containing one or more carbapenemase inhibitors was compared with the molecular test. Combined pre-diffusion was performed by preincubating the uninoculated agar with a CAZ-AVI disk, and then applying the bacterial inoculum and na ATM disk after removal of the CAZ-AVI disk. After incubation, halos were measured and correlated with the minimum inhibitory concentration (MIC) for ATM-AVI. ATM and ATM-AVI MICs were determined according to EUCAST. The identification of species by PCR evidenced the following frequencies: K. pneumoniae 75.2% (n=85); K. quasipneumoniae 16.8% (n=19), and K. variicola 8% (n=9). A fraction of 12.4% (n=14) of the isolates had the blaNDM and blaKPC genes and 87.6% (n=99) had only blaNDM. The analysis of the PFGE profiles of K. pneumoniae evidenced the presence of five predominant clonal groups. Isolates from the main clonal group Ap (n=16) were detected in the cities of São Paulo and Porto Alegre throughout the analyzed period. The clonal group Lp was detected in the cities of São Paulo and Recife 2019. The PFGE profiles of K. quasipneumoniae showed four predominant clonal groups, present only in the state of São Paulo, with persistence of the clonal group Aq since 2017. As for K. variicola, two predominant clonal groups Av and Bv were observed, the first present only in São Paulo since 2018 and the second in Porto Alegre only in 2019. Calculating the difference between the inhibition zone diameters of the MEM disk containing EDTA and phenylboronic acid (AFB) and the largest of the inhibition zone diameters obtained for MEM with EDTA or AFB, it was observed that all isolates with co-expression of KPC and NDM showed a difference 5 ≥mm. A fraction of 42.3% of isolates positive only for blaNDM showed sensitivity to ATM (MIC ≤ 4 mg/L). All tested isolates presented MIC for ATM-AVI ≤ 1/4 mg/L, being the MIC90 0.125/4 mg/l. In the combined pre-diffusion test, the smallest inhibition zone diameter obtained was 23 mm. The predominant species in the sample was K. pneumoniae, but a significant fraction of the other species in the complex was also observed in the sample. The clonal spread observed in this study contrasts with the clonal diversity described elsewhere in the world for NDM-producing isolates, except Greece and China. Considering the current cut-off points for ATM, it is likely that there is an adequate clinical response in the use of ATM-AVI in infections caused by NDM-producing and KPC-NDM co-producing isolates in Brazil. Using the cutoff value of 5 mm for the difference between inhibition zones, of MEM with AFB and EDTA and the second largest zone of MEM with inhibitor, the sensitivity was 100% and the specificity was 96.1%. The pre-diffusion method with CAZ-AVI and ATM is a simple method and the diameter ≥ 23 mm has excellent correlation with the MIC for ATM-AVI ≤ 1/4 mg/L


Subject(s)
Aztreonam/agonists , Diffusion , Klebsiella/metabolism , Methods , Carbapenems/adverse effects , Ceftazidime/pharmacology , Morbidity , Molecular Diagnostic Techniques/methods , Multiplex Polymerase Chain Reaction/instrumentation , Klebsiella pneumoniae/metabolism
2.
Rev. bras. enferm ; 72(3): 760-766, May.-Jun. 2019. tab
Article in English | BDENF, LILACS | ID: biblio-1013564

ABSTRACT

ABSTRACT Objective: To evaluate the risk factors related to Klebsiella pneumoniae carbapenemase infection after renal transplantation. Methods: This was a retrospective epidemiological (case-control) study, conducted from October 2011 to march 2016. Transplanted patients with infection by this bacteria during hospitalization were selected as cases. The controls were paired by age, sex, type of donor and transplant time. The proportion of cases and controls was 1:2. Results: Thirty hundred and five patients were included in the study (45 cases and 90 controls). The risk factors found for infection by KPC were: time of hospitalization after the transplant (OR: 4.82; CI95% 2.46-9.44), delayed kidney function (OR: 5.60; CI95% 1.91-11.01) and previous infectious for another microorganism ( OR: 34.13 CI95% 3.52-132.00). Conclusion: The risk of acquisition of this bacterium was directly related to invasive procedures and exposure to the hospital environment. The findings reinforce the importance of prevention measures and control of infection by this microorganism.


RESUMEN Objetivo: Evaluar los factores de riesgo relacionados con la infección por Klebsiella pneumoniae carbapenemasa después del trasplante renal. Método: Estudio retrospectivo epidemiológico (caso-control), realizado de octubre de 2011 a marzo de 2016. Pacientes transplantados con infección por esa bacteria durante la internación fueron seleccionados como casos. Los controles se parearon por edad, sexo, tipo de donante y tiempo de trasplante. La proporción de casos y controles fue de 1: 2. Resultados: Treinta y cinco pacientes fueron incluidos en el estudio (45 casos y 90 controles). Los factores de riesgo para la infección encontrados por KPC fueron: tiempo de hospitalización después del trasplante (OR: 4,82, IC95% 2,46-9,44), función renal retardada (OR: 5,60, IC95% 1, 91-11,01) y anterior infecciosa para otro microorganismo (OR: 34,13 IC95% 3,52-132,00). Conclusión: El riesgo de adquisición de esta bacteria estuvo directamente relacionado a procedimientos invasivos y exposición al ambiente hospitalario. Los hallazgos refuerzan la importancia de medidas de prevención y control de la infección por ese microorganismo.


Subject(s)
Humans , Male , Female , Adult , Pneumonia/ethnology , Bacterial Proteins/adverse effects , beta-Lactamases/adverse effects , Klebsiella Infections/etiology , Kidney Transplantation/adverse effects , Pneumonia/chemically induced , Pneumonia/epidemiology , Bacterial Proteins/metabolism , beta-Lactamases/metabolism , Brazil/epidemiology , Klebsiella Infections/metabolism , Klebsiella Infections/epidemiology , Case-Control Studies , Retrospective Studies , Risk Factors , Kidney Transplantation/methods , Klebsiella pneumoniae/metabolism , Klebsiella pneumoniae/pathogenicity , Middle Aged
3.
Braz. j. microbiol ; 49(supl.1): 93-100, 2018. tab, graf
Article in English | LILACS | ID: biblio-974332

ABSTRACT

Abstract Klebsiella pneumoniae is important human and animal pathogen that causes a wide spectrum of infections. In this study, isolates from cattle nasal swabs samples were identified by 16S rRNA, and to evaluate the antimicrobial susceptibility, virulence gene carrying levels, and multilocus sequence typing of K. pneumoniae isolates. 33 isolates of K. pneumoniae were isolated and identified in 213 nasal swabs samples, of which 12 were hypervirulent K. pneumoniae strains. Extended Spectrum Beta-Lactamases genes were found in 93.4% of the strains. Of which, TEM was the most prevalent (93.4%), followed by CTX-M and SHV were 57.6% and 39.4%, respectively. A main mutation pattern of quinoloneresistance-determining region, Thr83-Ieu and Asp87-Asn in gyrA and Ser87-Ile in parC, was detected in 33 K. pneumoniae isolates. All the isolates harbored at least two virulence factor genes, with ureA (97.0%) and wabG (91.0%) exhibiting high carriage rates in 33 K. pneumoniae isolates. MLST revealed 7 sequence types, of which 3 STs (2541, 2581 and 2844) were newly assigned. Using eBURST, ST2844 and ST2541 were assigned to new clonal complex 2844. Our study provides evidence and biological characteristics of K. pneumoniae isolates from cattle upper respiratory tract in Southwest China.


Subject(s)
Animals , Cattle , Bacterial Proteins/genetics , Klebsiella Infections/veterinary , Cattle Diseases/microbiology , Drug Resistance, Multiple, Bacterial , Virulence Factors/genetics , Klebsiella pneumoniae/isolation & purification , Klebsiella pneumoniae/drug effects , Anti-Bacterial Agents/pharmacology , Bacterial Proteins/metabolism , Klebsiella Infections/microbiology , China , Virulence Factors/metabolism , Multilocus Sequence Typing , Klebsiella pneumoniae/genetics , Klebsiella pneumoniae/metabolism
4.
Braz. j. microbiol ; 48(3): 493-498, July-Sept. 2017. tab, graf
Article in English | LILACS | ID: biblio-889153

ABSTRACT

Abstract Carbapenems are considered last-line agents for the treatment of serious infections caused by Klebsiella pneumoniae, and this microorganism may exhibit resistance to β-lactam antibiotics due to different mechanisms of resistance. We evaluated 27 isolates of K. pneumoniae resistant to carbapenems recovered from inpatients at the University Hospital of Santa Maria-RS from July 2013 to August 2014. We carried out antimicrobial susceptibility, carbapenemase detection, testing for the presence of efflux pump by broth microdilution and loss of porin by sodium dodecyl sulfate polyacrylamide gel electrophoresis. Genetic similarity was evaluated by ERIC-PCR. High levels of resistance were verified by the minimum inhibitory concentration for the antimicrobials tested. The blaKPC gene was present in 89% of the clinical isolates. Blue-Carba and combined disk with AFB tests showed 100% concordance, while the combined disk test with EDTA showed a high number of false-positives (48%) compared with the gold-standard genotypic test. Four isolates showed a phenotypic resistance profile consistent with the overexpression of the efflux pump, and all clinical isolates had lost one or both porins. The ERIC-PCR dendrogram demonstrated the presence of nine clusters. The main mechanism of resistance to carbapenems found in the assessed isolates was the presence of the blaKPC gene.


Subject(s)
Humans , Anti-Bacterial Agents/pharmacology , Carbapenems/pharmacology , Klebsiella Infections/microbiology , Klebsiella pneumoniae/drug effects , Bacterial Proteins/genetics , Bacterial Proteins/metabolism , Drug Resistance, Bacterial , Klebsiella pneumoniae/genetics , Klebsiella pneumoniae/isolation & purification , Klebsiella pneumoniae/metabolism , Microbial Sensitivity Tests
5.
Yonsei Medical Journal ; : 901-911, 2010.
Article in English | WPRIM | ID: wpr-33812

ABSTRACT

PURPOSE: Antimicrobial resistance monitoring could be a useful source of information for treating and controlling nosocomial infections. We analyzed antimicrobial resistance data generated by Korean Hospitals and by a commercial laboratory in 2005 and 2007. MATERIALS AND METHODS: Susceptibility data for 2005 and 2007 were collected from 37 and 41 hospitals, respectively, and from one commercial laboratory. Intermediate susceptibility was not included in the calculation of resistance rates. RESULTS: Methicillin-resistant Staphylococcus aureus (MRSA) (64%), third-generation cephalosporin-resistant Klebsiella pneumoniae (29%), fluoroquinolone-resistant Escherichia coli (27%), Pseudomonas aeruginosa (33%), and Acinetobacter spp. (48%), and amikacin-resistant P. aeruginosa (19%) and Acinetobacter spp. (37%) were prevalent in hospitals in 2007. A gradual increase of vancomycin-resistant Enterococcus faecium and imipenem-resistant Acinetobacter spp. was observed. Higher incidences of third-generation cephalosporin-resistant E. coli and K. pneumoniae and imipenem-resistant P. aeruginosa were found in the commercial laboratory than in the hospitals. CONCLUSION: Methicillin-resistant S. aureus, third-generation cephalosporin-resistant K. pneumoniae, and fluoroquinolone-resistant E. coli, P. aeruginosa and Acinetobacter spp. remain prevalent in Korea, while the incidence of vancomycin-resistant E. faecium and imipenem-resistant Acinetobacter spp. has increased gradually. The higher prevalences of third-generation cephalosporin-resistant E. coli and K. pneumoniae, and imipenem-resistant P. aeruginosa in the commercial laboratory are a new concern.


Subject(s)
Humans , Acinetobacter/metabolism , Bacterial Infections/drug therapy , Ceftazidime/pharmacology , Cross Infection/drug therapy , Drug Resistance, Bacterial , Escherichia coli/metabolism , Fluoroquinolones/pharmacology , Imipenem/pharmacology , Klebsiella Infections/drug therapy , Klebsiella pneumoniae/metabolism , Methicillin-Resistant Staphylococcus aureus/metabolism , Pseudomonas aeruginosa/metabolism , Republic of Korea , Vancomycin/pharmacology
6.
Rev. méd. Chile ; 132(10): 1173-1178, oct. 2004. graf, tab
Article in Spanish | LILACS | ID: lil-454001

ABSTRACT

BACKGROUND: Klebsiella pneumoniae is a pathogenic bacterium frequently isolated from nosocomial samples, specially the subspecie pneunonlae, with extensive antibiolic resistance profiles, including third generation cepbhalosporiis, aminoglycosides and quinolones. This is specially true for those strains producing extended spectrum beta lactamases (ESBL). AIM: To investigate the susceptibility to gentamicin, amikacin and ciprofloxacin and the presence of some aminogloycoside modifying enzyme (AMEs) among nosocomial strains of K pneumoniae subspecie pneumoniae producing ESBL. MATERIAL AND METHODS: The antibiotic resistant patterns and the level of resistance (minimal inhibitory concentration, MIC) of 100 strains, isoklted from sel ,eal bospitals of dcifferent Chilean cities, were deterl,in,ed. Tbe presence of some aminoglycosides modifying enzyme (AMEs) was investigated by PCR. RESULTS: Sixty five percent of strains were resistant to gentamicin, 47% were resistant to amikacin, and 29% were resistant to ciprofloxacin. The most frequent AMEs genes detected were the aac(6')-Ib gene (6'N-Acetyltransferase type Ib enzyme) in 69% of strains, conferring resistance to amikacin, kanamycin, tobramycin, and nieoniycin, and the gene aac(3)-IIa (3-Acetyltransferase type 3-IIa enzyme), in 36% of strains, conferring resistance to gentamlicin. CONCLUSIONS: Among nosocomial strains of K pneumoniae subspecie pneumoniae isolaterd from Chilean hospitals, there is an association between the production of ESBL and the resistance to others antimicrobial agents, especially aminoglycosides. Nevertheless, 71% of isolates are susceptible to ciprofloxacin.


Subject(s)
Humans , Anti-Infective Agents , Aminoglycosides/pharmacology , Ciprofloxacin/pharmacology , Klebsiella pneumoniae/drug effects , Drug Resistance, Bacterial , beta-Lactamases/biosynthesis , Anti-Bacterial Agents/pharmacology , Amikacin/pharmacology , Aminoglycosides/metabolism , Gentamicins/pharmacology , Cross Infection/microbiology , Klebsiella pneumoniae/metabolism
7.
Article in English | WPRIM | ID: wpr-20660

ABSTRACT

The 5th year KONSAR surveillance in 2001 was based on routine test data at 30 participating hospitals. It was of particular interest to find a trend in the resistances of enterococci to vancomycin, of Enterobacteriaceae to the 3rd generation cephalosporin and fluoroquinolone, and of Pseudomonas aeruginosa and acinetobacters to carbapenem. Resistance rates of Gram-positive cocci were: 70% of Staphylococcus aureus to oxacillin; 88% and 16% of Enterococcus faecium to ampicillin and vancomycin, respectively. Seventy-two percent of pneumococci were nonsusceptible to penicillin. The resistance rates of Enterobacteriaceae were: Escherichia coli, 28% to fluoroquinolone; Klebsiella pneumoniae, 27% to ceftazidime, and 20% to cefoxitin; and Enterobacter cloacae, > or =40% to cefotaxime and ceftazidime. The resistance rates of P. aeruginosa were 21% to ceftazidime, 17% to imipenem, and those of the acinetobacters were > or =61% to ceftazidime, aminoglycosides, fluoroquinolone and cotrimoxazole. Thirty-five percent of non-typhoidal salmonellae were ampicillin resistant, and 66% of Haemophilus influenzae were -lactamase producers. Notable changes over the 1997-2001 period were: increases in vancomycin-resistant E. faecium, and amikacin- and fluoroquinolone-resistant acinetobacters. With the increasing prevalence of resistant bacteria, nationwide surveillance has become more important for optimal patient management, for the control of nosocomial infection, and for the conservation of the newer antimicrobial agents.


Subject(s)
Humans , Anti-Bacterial Agents/pharmacology , Cephalosporins/pharmacology , Drug Resistance, Microbial , Enterococcus faecium/metabolism , Imipenem/pharmacology , Klebsiella pneumoniae/metabolism , Korea , Pseudomonas aeruginosa/metabolism , Time Factors , Vancomycin/pharmacology
8.
Article in English | WPRIM | ID: wpr-109217

ABSTRACT

Despite septic arthritis is increasingly being reported in elderly patients with diabetes or alcoholism, reported cases of spontaneous bacterial arthritis in cirrhotic patients are extremely rare. We present the first reported case of K. pneumoniae septic arthritis and spontaneous bacterial peritonitis in a cirrhotic patient with hepatocellular carcinoma. K. pneumoniae, one of the most common causative organisms of spontaneous bacterial peritonitis in cirrhotic patients, was isolated from both the blood and the joint fluid, which suggests that the route of infection was hematogenous. After the treatment with cefotaxime and closed tube drainage, the condition of the patient was improved, and subsequently, the joint fluid became sterile and the blood cultures were proved negative. Therefore, this case provides further evidence for the mode of infection being bacteremia in cirrhotic patients and suggests that the enteric bacteremia in cirrhotics may cause infection in different organ systems.


Subject(s)
Aged , Animals , Female , Humans , Arthritis, Infectious/blood , Carcinoma, Hepatocellular/pathology , Fatal Outcome , Joints/chemistry , Klebsiella pneumoniae/metabolism , Liver Cirrhosis/microbiology , Liver Neoplasms/pathology , Peritonitis/blood
9.
Article in English | WPRIM | ID: wpr-164221

ABSTRACT

With acupuncture treatment becoming an increasingly popular analgesic, there have been increasing reports on its associated complications. Although pneumothorax is the most frequently reported injury caused by acupuncture needles, infectious complications may not be uncommon. Most infectious complications show less serious clinical manifestations than pneumothorax, but retroperitoneal or intraabdominal abscess caused by acupuncture may be much more serious conditions. We experienced a 56-yr-old male diabetic patient presenting with serious retroperitoneal abscess after acupuncture treatments. Emergency operative drainage with adequate antibiotic therapy was performed. Bacterial culture of blood and closed pus specimens recovered Klebsiella pneumoniae. In addition to application of better knowledge on anatomy, appropriate antiseptic practice by practitioners will reduce many serious complications associated with acupuncture.


Subject(s)
Humans , Male , Middle Aged , Abdominal Abscess/diagnostic imaging , Acupuncture , Acupuncture Therapy/adverse effects , Anti-Bacterial Agents/therapeutic use , Diabetes Mellitus/complications , Klebsiella Infections/diagnosis , Klebsiella pneumoniae/metabolism , Sepsis/diagnosis , Tomography, X-Ray Computed
10.
Article in English | WPRIM | ID: wpr-164220

ABSTRACT

Emphysematous prostatic abscess is a very rare form of prostatitis. Emphysematous prostatic abscess due to Klebsiella pneumoniae may have a poor prognosis according to a few previous reports. We report a rare case of successfully treated emphysematous prostatic abscess with cystitis due to Klebsiella pneumoniae in a 50-yr-old man with 15-yr history of diabetes mellitus. The patient was referred to the emergency room of our hospital. The KUB film revealed gas shadows in the lower pelvic area suggestive of emphysematous cystitis or emphysematous prostatic abscess. The gas was mainly occupying the prostate and was also seen in the bladder on pelvic CT. The patient was successfully treated with long-term antibiotic use and additional percutaneous drainage of the abscess. Emphysematous prostatic abscess may be misdiagnosed as emphysematous cystitis due to the similar location of gas shadows on radiography. Computerized tomography and transrectal ultrasonography are helpful in making the diagnosis of emphysematous prostatic abscess. Appropriate use of effective antibiotics with drainage of pus is the best treatment. This case emphasizes the importance of timely and accurate diagnosis followed by appropriate treatment in emphysematous prostatic abscess in diabetic patients.


Subject(s)
Humans , Male , Middle Aged , Abscess , Anti-Bacterial Agents/therapeutic use , Cystitis/diagnosis , Diabetes Mellitus/complications , Drainage , Emphysema/diagnosis , Klebsiella Infections/diagnosis , Klebsiella pneumoniae/metabolism , Prostate/microbiology , Prostatic Diseases/diagnosis
11.
Säo Paulo; s.n; 1997. 125 p. ilus, tab, graf.
Thesis in Portuguese | LILACS | ID: lil-198601

ABSTRACT

O presente trabalho estuda o processo fermentativo de produçÝo de 2, 3-butanodiol, a partir de hidrolisado hemicelulósico de eucalipto, empregando a bactéria Klebsiella pneumoniae. Primeiramente foram comparados diversos tratamentos para a remoçÝo de inibidores do crescimento bacteriano presentes na matéria-prima, verificando-se a necessidade de se combinar a precipitaçÝo por variaçÝo do pH com a adsorçÝo por carvÝo ativo. Em seguida estudou-se as condiçSes de fermentaçÝo para a conduçÝo do processo em regime descontínuo alimentado em reator, o qual se mostrou mais eficiente que o regime descontínuo em frascos agitados. Finalmente avaliou-se a influência da concentraçÝo de substrato do meio de alimentaçÝo ('S IND. i') e da vazÝo de alimentaçÝo (phi), sobre a cinética do processo


Subject(s)
Eucalyptus/microbiology , Fermentation , Klebsiella pneumoniae/metabolism , Biotechnology
12.
Article in English | IMSEAR | ID: sea-18748

ABSTRACT

K. pneumoniae strains recovered as pure or predominant isolate from stool specimens of 50 children below three years of age, presenting with acute watery diarrhoea, were studied for heat-labile enterotoxin production. Twenty three (46%) of the 50 crude toxin concentrates showed positivity in rabbit ileal loops and skin permeability tests. Antigenically 17 (34%) and 20 (40%) of the toxin extracts reacted with immuno-purified anti H-LT antibody in latex particle agglutination and immuno-dot blot assays respectively. Polyacrylamide-gel electrophoresis, Western-blotting and enzyme-immunoassay revealed heat-labile enterotoxin and its subunits in 19 (68%) of 28 extracts tested. In 5 of 10 strains tested the toxigenicity could be transferred to recipient Escherichia coli J-35 in plasmid transfer experiments. Klebsiella induced enterotoxigenic diarrhoea and produced a heat-labile toxin which seems to be biologically, antigenically and possibly genetically related to the heat-labile toxin of the cholera-coli family.


Subject(s)
Acute Disease , Child, Preschool , Diarrhea/microbiology , Diarrhea, Infantile/microbiology , Enterotoxins/biosynthesis , Feces/microbiology , Humans , Infant , Klebsiella Infections/microbiology , Klebsiella pneumoniae/metabolism
13.
Article in English | IMSEAR | ID: sea-16337

ABSTRACT

The incidence of bacteriocinogeny among 117 clinical isolates of Klebsiella pneumoniae was examined using two systems of indicators-K. pneumoniae WC indicator and the Abbott-Shannon set of indicators. None of the isolate tested produced bacteriocin active on K. pneumoniae WC while 23 per cent positivity was observed with the Abbott-Shannon indicators. Most of the bacteriocin producers were urinary isolates (53.8%) followed by 15.3 and 30.7 per cent respectively of faecal and miscellaneous isolates. Our results indicate the advantages of using a set of indicators over a single indicator strain.


Subject(s)
Bacteriocins/biosynthesis , Feces/microbiology , Humans , Klebsiella pneumoniae/metabolism , Urine/microbiology
14.
Rev. argent. microbiol ; 21(1): 31-5, ene.-mar. 1989. tab
Article in Spanish | LILACS | ID: lil-78201

ABSTRACT

Se investigó la produción de bacteriocina en cepas de Klebsiella pneumoniae aisladas de pacientes con diversas infecciones. Mediante el método de estrías cruzadas se encontraron dos cepas capaces de inhibir el crecimiento de un alto número de bacterias de la misma especie. La Klebocina K150 presentó mayores halos de inhibición y un espectro de Klebsielas sensibles más amplio que la K6. Ambas se produjeron en medios complejos pero no se pusieron en evidencia en los medios de cultivo sintéticos empleados; la cepa 150 fue incapaz de elaborar bacteriocina en agar nutritivo, triptosa-extracto de carne y eosina-azul de metileno, mientras que la cepa 6 sintetizó la klebocina en todos excepto en triptosa-extracto de carne. Laa K150 es más susceptible al tratamiento con calor que la K6. Se estimó el peso molecular de las bacteriocinas como inferior a 10.000 D. Laa producción de bacteriocina se presentó asociada a la capacidad de hemolizar glóbulos rojos y a la actividad de lipasa. Además las cepas Klebocina-positivas se caracterizaron por un espectro de multiresistencia a antimicrobianos que las diferenció de otras cepas, resistentes


Subject(s)
Bacteriocins/metabolism , Klebsiella pneumoniae/metabolism , Bacteriocins/biosynthesis , Culture Media
15.
Rev. latinoam. microbiol ; 27(2): 83-7, abr.-jun. 1985. tab
Article in Spanish | LILACS | ID: lil-35111

ABSTRACT

Se investigó la actividad hemolítica de Klebsiella pneumoniae, empleando cepas de referencia y cepas aisladas de infecciones. Todas las bacterias estudiadas resultaron hemolíticas en forma selectiva sobre eritrocitos de conejo. El frío intensificó el efecto lítico sobre los glóbulos rojos. Se estimó la capacidad hemolítica de las cepas mediante el diámetro de los halos producidos alrededor de orificios inoculados con 5 micron**l de suspensiones bacterianas. Cuando se realizó la detección de hemolisis en medios líquidos, sólo fue posible evidenciar lisis franca al tratar los cultivos con ciertos agentes reductores; de los cuales el más efectivo resultó el 2 mercaptoetanol. A la misma concentración los demás agentes químicos utilizados dieron menor porcentaje de eritrocitos lisados. La actividad hemolítica apareció en los cultivos durante la fase exponencial del crecimiento bacteriano y al cabo de 24 horas disminuyó al 33% del valor máximo alcanzado. Tanto la hemolisina cruda como la purificada reqirieron SH-activación y fueron inhibidas por suero


Subject(s)
Rabbits , Animals , Erythrocytes/microbiology , Hemolysin Proteins/metabolism , Hemolysis , Klebsiella pneumoniae/metabolism
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