Résumé
RESUMEN Introduction La epistaxis es un motivo frecuente de consulta en otorrinolaringología pediátrica. Diversos factores se han asociado, existiendo tanto causas locales como sistémicas. Ciertos estudios en adultos, han sugerido la asociación de colonización nasal por Staphylococcus aureus con la recurrencia de la epistaxis. Este hallazgo en población pediátrica tendría un potencial rol dentro del tratamiento y sería un posible blanco para profilaxis. Objetivo Comparar la prevalencia de colonización nasal por S. aureus en pacientes pediátricos con epistaxis recurrente, en el Servicio de Otorrinolaringología del Hospital Barros Luco Trudeau, respecto a pacientes sin este antecedente. Material y método Estudio caso-control, definiendo caso como pacientes entre 2 y 15 años que consultaron por cuadros de epistaxis anterior recurrente. Se tomaron cultivos nasales a ambos grupos. Resultados Se incluyeron 46 pacientes con epistaxis y 45 controles. La prevalencia de S. aureus fue de 39% en los casos y 37% en los controles, sin diferencias estadísticamente significativas. Al examen físico de la mucosa nasal, ninguna de las características estudiadas mostró una relación significativa con la presencia de S. aureus. Conclusión La colonización nasal de S. aureus de niños con y sin epistaxis recurrente no varía considerablemente. En este estudio, la presencia de S. aureus no se asoció estadísticamente a epistaxis recurrente.
ABSTRACT Introduction: Epistaxis is a frequent reason for consultation in pediatric otolaryngology. Several factors have been associated, both local and systemic. Some studies in adult population, have suggested the association of nasal colonization by Staphylococcus aureus with the recurrence of epistaxis. Finding this association in pediatric population could have a potential role in treatment and also as a possible target for prophylaxis. Aim: To compare the prevalence of nasal colonization by S. aureus between pediatric patients with recurrent epistaxis and controls with no previous recurrent epistaxis, in the Service of Otorhinolaryngology in Barros Luco Trudeau Hospital. Material and method: Case-control study, defining case as patients between 2 and 15 years who consulted for recurrent anterior epistaxis. Nasal cultures were taken from both groups. Results: 46 patients with epistaxis and 45 controls were included. The prevalence of S. aureus was 39% in the case group and 37% in the controls, without statistically significant differences. At the physical examination of the nasal mucosa, none of the characteristics studied showed a significant relationship with the presence of S. aureus. Conclusion: Nasal colonization of S. aureus in children with and without recurrent epistaxis does not vary considerably. In this study, the presence of S. aureus was not statistically associated with recurrent epistaxis.
Sujets)
Humains , Mâle , Femelle , Enfant d'âge préscolaire , Enfant , Adolescent , Infections à staphylocoques/complications , Staphylococcus aureus , Épistaxis/étiologie , Nez/microbiologie , Résistance microbienne aux médicaments , Études cas-témoins , Muqueuse nasaleRésumé
Abstract Introduction: After post-septoplasty nasal packing removal, a certain proportion of nasal secretion occurs, leading to local and sometimes systemic infections. Objective: The aim was to determine if standardized dry ivy leaf extract application after nasal packing removal influences the reduction of nasal secretion and diminish the occurrence of local infections. Methods: The study included 70 post-septoplasty patients (divided into two equal groups) whose nasal packing was removed on the third day after the procedure. Group I was treated with standardized dry ivy leaf extract syrup along with regular nasal irrigation for the five days after the nasal packing removal whereas the Group II had only nasal lavage. On the sixth day after nasal packing removal, the quantity of nasal secretion was determined using a visual analog scale and nasal endoscopic examination. Results: The group treated with standardized dry ivy leaf extract syrup had significantly lesser nasal secretion both by subjective patients' assessment (p < 0.001) and by nasal endoscopic examination (p = 0.003). The post-surgical follow up examination on the sixth day after nasal packing removal showed no development of local infection in the Group I, while in the Group II a local infection was evident in five patients (14.29%) and antibiotic therapy was required. Conclusion: The use of the standardized dry ivy leaf extract after nasal packing removal significantly lowers the proportion of nasal secretion.
Resumo Introdução: Após a remoção do tampão nasal pós-septoplastia, ocorre produção de secreção nasal, predispondo infecções locais e, por vezes, sistêmicas. Objetivo: O objetivo foi determinar se a aplicação do extrato padronizado de folhas de hera seca após a remoção do tampão nasal influencia a redução da secreção nasal e diminui a ocorrência de infecções locais. Método: O estudo incluiu 70 pacientes pós-septoplastia (divididos em dois grupos iguais) cujo tampão nasal foi retirado no terceiro dia após o procedimento. O grupo I foi tratado com xarope padronizado de extrato de folha seca de hera juntamente com irrigação nasal regular por cinco dias após a remoção do tamponamento nasal, enquanto ao grupo II foi recomendado apenas lavagem nasal. No sexto dia após a remoção do tampão nasal, a quantidade de secreção nasal foi determinada pela escala EVA (escala visual analógica) e pelo exame endoscópico nasal. Resultados: O grupo tratado com xarope de extrato seco de folhas de hera apresentou secreção nasal significativamente menor tanto pela avaliação subjetiva dos pacientes (p < 0,001) quanto pelo exame endoscópico nasal (p = 0,003). O exame de acompanhamento pós-cirúrgico no sexto dia após a remoção do tampão nasal não mostrou desenvolvimento de infecção local nos pacientes do grupo I, enquanto que no grupo II, cinco apresentaram sinais de infecção local (14,29%) com necessidade de antibioticoterapia. Conclusão: O uso do extrato padronizado de folhas secas de hera após a remoção do tampão nasal reduz significativamente a produção de secreção nasal.
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Humains , Mâle , Femelle , Adolescent , Adulte , Adulte d'âge moyen , Jeune adulte , Soins postopératoires/méthodes , Rhinoplastie/méthodes , Extraits de plantes/usage thérapeutique , Hedera/composition chimique , Septum nasal/chirurgie , Épistaxis/prévention et contrôle , Nez/microbiologie , Feuilles de plante/composition chimique , Hémorragie postopératoire/prévention et contrôle , Phytothérapie , Antibactériens/usage thérapeutiqueRésumé
Abstract Nasal colonization with methicillin-resistant Staphylococcus aureus (MRSA) have increasingly been reported in healthy communities. This study aimed to assess the rate of S. aureus in general and MRSA in particular from nasal secretion of children in daycare centers in Vitória da Conquista, Brazil. The isolates were identified based on morphology, biochemical tests and by PCR. Detection of virulence genes, biofilm production, and susceptibility test by disk diffusion agar were performed. MRSA isolates were characterized by spa, SCCmec, and multilocus sequence typing (MLST). S. aureus were recovered from 70 (47.3%) of 148 children. Among the 11 MRSA strains (15.7%), two SCCmec types (IV and V) were detected. MLST identified four STs related to three clonal complexes (CC): 5, 45, and 398. Four spa types were found circulating in this setting. Resistance of S. aureus isolates to ampicillin, erythromycin, ciprofloxacin, clindamycin, and tetracycline was 80%, 32.8%, 7.1%, 7.1% and 4.3%, respectively. One isolate presented intermediate resistance to vancomycin detected by Etest methodology. All strains were biofilm producers. The virulence genes seb, sec, spa, and pvl were detected in some isolates. This study revealed a high rate of children carrying MRSA among healthy attendees in daycare centers in Vitória da Conquista, Brazil.
Sujets)
Humains , Mâle , Femelle , Nourrisson , Enfant d'âge préscolaire , Enfant , Infections à staphylocoques/microbiologie , Garderies d'enfants , Nez/microbiologie , Infections communautaires/microbiologie , Biofilms/croissance et développement , Facteurs de virulence , Tests d'agents antimicrobiens par diffusion à partir de disques , Staphylococcus aureus résistant à la méticilline/isolement et purification , Staphylococcus aureus résistant à la méticilline/effets des médicaments et des substances chimiques , Staphylococcus aureus résistant à la méticilline/pathogénicité , Génotype , Antibactériens/pharmacologieRésumé
Antecedentes/Objetivo. Describir el perfil epidemiológico de la portación nasal de cepas de Staphylococcus aureus (S. aureus), su resistencia a antibióticos y la presencia de los genes de leucocidina de Panton-Valentine (LPV) y mecA en niños en edad escolar que viven en zonas de gran altitud del sudoeste de China. Métodos. En el estudio transversal, se analizaron hisopados nasales de estudiantes a fin de detectar S. aureus. Se realizó la prueba de la reacción en cadena de la polimerasa (RCP) para identificar los genes de LPV y mecA. Resultados. Del total de 314 niños, se detectó S. aureus en el 5,10% (16/314). La resistencia de las cepas aisladas a la penicilina, eritromicina, clindamicina, rifampicina y cefoxitina fue del 100%, 81,3%, 81,3%, 0,0% y 6,3%, respectivamente. Ninguna de las cepas mostró resistencia a la vancomicina. Se detectó la expresión del gen mecA en 3 cepas aisladas, y 10 cepas aisladas dieron resultado positivo para el gen de LPV. Conclusión. Se detectó S. Aureus en el 5,10% (16/314) de la población del estudio; el 0,96% (3 /314) presentó S. Aureus resistente a la meticilina (SARM). Además, se detectó la expresión de los genes de LPV y mecA en 10 y 3 cepas aisladas, respectivamente.
Background/Aim. To describe the epidemiological profile of nasal carriage of Staphylococcus aureus (S. aureus) strains, its antibiotic resistance and mecA and Panton Valentine leukocidin (PVL) genes presence, in school children residing in high altitude areas of Southwestern China. Methods. The cross sectional study screened nasal swabs taken from students for S. aureus. PCR was performed to identify mecA and PVL genes. Results. Of the total 314 children 5.10% (16/314) was detected S. aureus. The resistance of isolated strains to penicillin, erythromycin, clindamycin, rifampicin and cefoxitin was 100%, 81.3%, 81.3%, 0.0%, and 6.3% respectively. No strains demonstrated resistance to vancomycin; expression of mecA gene was detected in 3 isolates and 10 isolates were PVL-positive. Conclusion. S. aureus was detected in 5.10% (16/314) of the study population; 0.96% (3/314) had methicillin resistant S. aureus (MRSA); expression of the mecA and PVL genes were detected in 3 and 10 isolates respectively.
Sujets)
Humains , Mâle , Femelle , Enfant , Staphylococcus aureus/effets des médicaments et des substances chimiques , État de porteur sain/microbiologie , Nez/microbiologie , Altitude , Staphylococcus aureus/isolement et purification , Staphylococcus aureus/génétique , Protéines bactériennes/génétique , Toxines bactériennes/génétique , Chine , Études transversales , Résistance bactérienne aux médicaments , Protéines de liaison aux pénicillines/génétique , Exotoxines/génétique , Leucocidine/génétiqueRésumé
Abstract Objective Analyze nasal colonization by oxacillin-sensitive and oxacillin-resistant Staphylococcus aureus in people with HIV/AIDS (PWHA) at days 1 and7 of hospitalization. METHOD A prospective observational study conducted in a hospital in the countryside of the state of São Paulo. Nasal swab samples were collected and analyzed through microbiological identification, at days 1 and 7 of hospitalization of PWHA, between August 2011 and January 2014. Data were analyzed via IBM SPSS(r), version 20.0. RESULTS Nasal secretion samples were collected from 187 (50.1%) PWHA at days 1 and 7 of hospitalization. Of these, Staphylococcus aureus was identified in 64 (34.2%) PWHA. CONCLUSION At day 1 of hospitalization, 27 PWHA were identified with Staphylococcus aureus; 27 PWHA presented colonization by Staphylococcus aureus at days 1 and 7, and 10 PWHA only at day 7. Of 64 PWHA colonized by Staphylococcus aureus, the susceptibility profile of isolated Staphylococcus aureus was oxacillin-resistant in 25 PWHA.
Resumen OBJETIVO Analizar la colonización nasal por Staphylococcus aureus sensibles y resistentes a la oxacilina de personas viviendo con VIH/Sida (PVVS) el primer y séptimo día de estancia hospitalizar. MÉTODO Estudio prospectivo observacional, realizado en un hospital del interior del Estado de São Paulo. Fueron recogidas y analizadas, mediante identificación microbiológica, muestras de swab nasal el primer y el séptimo día de estancia hospitalaria de PVVS, en el período de agosto/2011 a enero/2014. Se realizó el análisis de los datos mediante el IBM SPSS(r), versión 20.0. RESULTADOS En 187 (50,1%) PVVS, fueron recogidas muestras de secreción nasal el primer y séptimo día de estancia hospitalaria. De esas, en 64 (34,2%) fue identificado Staphylococcus aureus. CONCLUSIÓN El primer día de estancia se observó 27 PVVS colonizadas por Staphylococcus aureus; en 27 PVVS hubo la persistencia de la colonización por Staphylococcus aureus el primer y el séptimo día; en 10 PVVS, solo el séptimo día. De las 64 PVVS colonizadas por Staphylococcus aureus, en 25 el perfil de susceptibilidad del Staphylococcus aureus aislado fue resistente a la oxacilina.
Resumo OBJETIVO Analisar a colonização nasal por Staphylococcus aureus sensíveis e resistentes à oxacilina de pessoas vivendo com HIV/aids (PVHA) no primeiro e no sétimo dia de internação hospitalar. MÉTODO Estudo prospectivo observacional realizado em um hospital do interior paulista. Foram coletadas e analisadas, por meio de identificação microbiológica, amostras de swab nasal no primeiro e no sétimo dia de internação hospitalar de PVHA, no período de agosto/2011 e janeiro/2014. A análise dos dados foi realizada por meio do IBM SPSS(r), versão 20.0. RESULTADOS Em 187 (50,1%) PVHA foram coletadas amostras de secreção nasal no primeiro e sétimo dia de internação. Destas, em 64 (34,2%) foi identificado Staphylococcus aureus. CONCLUSÃO No primeiro dia de internação observou-se 27 PVHA colonizadas por Staphylococcus aureus; em 27 PVHA houve a persistência da colonização por Staphylococcus aureus no primeiro e no sétimo dia; em 10 PVHA, somente no sétimo dia. Das 64 PVHA colonizadas por Staphylococcus aureus, em 25 o perfil de suscetibilidade do Staphylococcus aureus isolado foi resistente à oxacilina.
Sujets)
Humains , Mâle , Femelle , Adulte , Adulte d'âge moyen , Jeune adulte , Oxacilline/pharmacologie , Staphylococcus aureus/effets des médicaments et des substances chimiques , Antibactériens/pharmacologie , Staphylococcus aureus/isolement et purification , Tests de sensibilité microbienne , Infections à VIH/thérapie , Nez/microbiologie , Études prospectives , Syndrome d'immunodéficience acquise/thérapie , HospitalisationRésumé
ABSTRACT Purpose: To compare the conjunctival, lacrimal sac, and nasal flora cultures and conjunctival normalization time following external (EX-), endoscopic (EN-), and transcanalicular multidiode laser (TC-) dacryocystorhinostomy (DCR) and to evaluate the relationship between culture positivity and surgical success. We further performed antibiotic sensitivity analyses for lacrimal sac culture samples. Methods: A total of 90 patients with primary acquired nasolacrimal duct obstruction were recruited and divided into EX-DCR (n=32), EN-DCR (n=28), and TC-DCR (n=30) groups. Conjunctival, nasal, and lacrimal sac cultures and antibiograms were analyzed. Results: In all three groups, coagulase-negative Staphylococcus (CNS) was predominantly isolated preoperatively from the conjunctiva, nose, and lacrimal sac and postoperatively from the conjunctiva. Preoperative and postoperative conjunctival culture positivity rates were similar between all the groups (p>0.05). A statistically significant difference in the growth rate of culture in the lacrimal sac was observed between the three groups (p=0.001). CNS and Staphylococcus aureus cultures were predominantly sensitive to linezolid, teicoplanin, tigecycline, vancomycin, and mupirocin. Conjunctival normalization times were similar between the three groups (p>0.05). Anatomical and functional success rates were not found to be significantly correlated with preoperative conjunctival and lacrimal sac culture positivity (p>0.05). Conclusions: Similar rates of preoperative and 1-week postoperative conjunctival culture positivity were observed in all the groups; a significantly lower bacterial growth rate was observed in postoperative conjunctival cultures. CNS was the most commonly isolated organism. Bacterial growth rates in the lacrimal sac samples were significantly higher in the EN-DCR group. Bacterial growth rates obtained preoperatively from the conjunctival and lacrimal sac culture samples were not correlated with DCR success.
RESUMO Objetivo: Comparar a flora conjuntival, do saco lacrimal e nasal com o tempo de normalização após dacriocistorrinostomia (DCR) externa (EX-), endoscópica (EN-) e transcanalicular a laser de multi diodo (TC-) para correlacionar a positividade da cultura com o sucesso cirúrgico, assim como identificar a sensibilidade aos antibióticos em amostras de saco lacrimal. Métodos: Neste estudo prospectivo, 90 pacientes com obstrução do canal nasolacrimal adquirida primária foram incluídos e divididos em grupos EX-DCR (n=32), EN-DCR (n=28) e TC-DCR (n=30). Culturas e antibiogramas conjuntivais, nasais e do saco lacrimal foram analisados. Resultados: Staphylococcus coagulase-negativo (CNS) foi o organismo predominante isolado no pré-operatório (conjuntiva e nariz), no transoperatório (saco lacrimal) e pós-operatório (conjuntiva), nos 3 grupos. Taxas de positividade de cultura da conjuntiva pré- e pós-operatórias nos três grupos foram semelhantes (p>0,05). A diferença nas taxas de crescimento do saco lacrimal dos três grupos foi estatisticamente significativa (p=0,001). CNS e S. aureus foram mais sensíveis a linezolida, teicoplanina, a tigeciclina, vancomicina e mupirocina. O tempo de normalização conjuntival foi semelhante nos três grupos (p>0,05). Não houve relação estatisticamente significativa entre as taxas de sucesso anatômicas e funcionais e a positividade da cultura conjuntival e de saco lacrimal pré-operatória (p>0,05). Conclusões: Pacientes submetidos a EX-DCR, EN-DCR, e TC-DCR apresentaram positividades de cultura conjuntival semelhantes no pré-operatório e na 1a semana pós-operatória. Houve uma redução significativa na taxa de crescimento das culturas da conjuntiva pós-operatórias. O organismo mais comumente isolado foi o CNS. A taxa de crescimento de bactérias a partir do saco lacrimal foi significativamente maior no grupo PT-DCR. O crescimento bacteriano da conjuntiva no pré-operatório e de amostras do saco lacrimal no transoperatório não se relacionaram com o sucesso da DCR.
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Humains , Mâle , Femelle , Enfant d'âge préscolaire , Enfant , Adolescent , Adulte , Adulte d'âge moyen , Sujet âgé , Sujet âgé de 80 ans ou plus , Jeune adulte , Dacryo-cysto-rhinostomie/méthodes , Conjonctive/microbiologie , Appareil lacrymal/microbiologie , Conduit nasolacrymal/chirurgie , Conduit nasolacrymal/microbiologie , Valeurs de référence , Staphylococcus/isolement et purification , Bactéries/isolement et purification , Tests de sensibilité microbienne , Nez/microbiologie , Études prospectives , Analyse de variance , Statistique non paramétrique , Lasers à semiconducteur/usage thérapeutique , Chirurgie endoscopique par orifice naturel/méthodes , Obstruction du canal lacrymal/microbiologieRésumé
The study of HIV transmission and the implementation of AIDS prevention actions recognize the importance of social networks in the transmission of the disease, the adherence to treatment and the quality of life of those infected. For this relevance there was a review of articles on social support networks to people living with HIV /AIDS available in the Virtual Health Library (VHL) were published in Brazil between 2002 and 2012. In this study 31 articles were used from journals covering the following áreas: Nursing (n = 15), Psychology (n = 6) and Science Health / Biomedica (n = 6), were included, which some principal authors were affiliated to higher education public institutions (n = 17). In relation to the methodology used, priority wasgiven to conducting: qualitative research (n = 18), cross-sectional studies (n = 19) and studies that involved talking to people living with HIV/AIDS (n = 13). Particular importance was placed on analytic categories related to: adherence to treatment (n = 6), the family (n = 4), vulnerability (n = 3) and support from social networks (n = 5). Within this paper we argue for more investments into studies that focus on the family, carers and their households, as well as deepening the theoretical study of the themes discussed and the use of developed theories for the analysis of Social Networks.
O estudo da transmissão do HIV e a implementação de ações de prevenção da AIDS reconhece a importância das redes sociais na contaminação, adesão ao tratamento e qualidade de vida das pessoas infectadas. Por tal relevância, realizou-se uma revisão de artigos sobre redes sociais de apoio às pessoas que vivem com HIV/ AIDS, disponíveis na Biblioteca Virtual em Saúde (BVS) e publicados no Brasil no período de 2002 a 2012. Encontraram-se 31 artigos em revistas de Enfermagem (n = 15), Psicologia (n = 6) e Ciências da Saúde/Biomédicas (n = 6), produzidos por primeiros autores associados a Instituições de Ensino Superior públicas (n = 17). Quanto à metodologia, priorizou-se o método qualitativo (n = 18), estudos transversais (n = 19) e a participação exclusiva de pessoas que vivem com HIV/AIDS (n = 13). Houve predomínio de categorias analíticas relacionadas à adesão ao tratamento (n = 6), família (n = 4), vulnerabilidade (n = 3) e apoio/suporte social/ rede de apoio (n = 5). Discute-se a necessidade de investimento em estudos que privilegiem familiares e cuidadores como participantes e seus domicílios como lócus de investigação, bem como maior aprofundamento teórico nos estudos das temáticas abordadas e utilização de teorias desenvolvidas para análise de Redes Sociais.
Sujets)
Humains , Mâle , Femelle , Adulte , Adulte d'âge moyen , Sujet âgé , Sujet âgé de 80 ans ou plus , Jeune adulte , Antibactériens/administration et posologie , Antibioprophylaxie , Mupirocine/administration et posologie , Povidone iodée/administration et posologie , Infections à staphylocoques/prévention et contrôle , Staphylococcus aureus/effets des médicaments et des substances chimiques , Infection de plaie opératoire/prévention et contrôle , Administration par voie nasale , Arthroplastie , Analyse en intention de traitement , Mupirocine/pharmacologie , Nez/microbiologie , Onguents , Povidone iodée/pharmacologie , Arthrodèse vertébraleRésumé
Mycoplasma (M.) hyorhinis and M. hyosynoviae are pathogens known to cause disease in pigs post-weaning. Due to their fastidious nature, there is increased need for culture-independent diagnostic platforms to detect these microorganisms. Therefore, this study was performed to develop and optimize quantitative real-time PCR (qPCR) assays to rapidly detect M. hyorhinis and M. hyosynoviae in pen-based oral fluids as well as nasal and tonsillar fluids as proxies for samples used in swine herd surveillance. Two methods of genomic DNA extraction, automated versus manual, were used to compare diagnostic test performance. A wean-to-finish longitudinal study was also carried out to demonstrate the reproducibility of using pen-based oral fluids. Overall, pen-based oral and tonsillar fluids were more likely to be positive for both types of bacteria whereas only M. hyorhinis was detected in nasal fluids. DNA extraction protocols were shown to significantly influence test result. Although the initial detection time somewhat differed, both organisms were repeatedly detected in the longitudinal study. Overall, this study evaluated two qPCR methods for rapid and specific detection of either mycoplasma. Results from the present investigation can serve as a foundation for future studies to determine the prevalence of the two microorganisms, environmental load, and effectiveness of veterinary interventions for infection control.
Sujets)
Animaux , Femelle , Tests diagnostiques courants/méthodes , Études longitudinales , Bouche/microbiologie , Infections à Mycoplasma/diagnostic , Mycoplasma hyorhinis/isolement et purification , Mycoplasma hyosynoviae/isolement et purification , Nez/microbiologie , Tonsille palatine/microbiologie , Réaction de polymérisation en chaine en temps réel/médecine vétérinaire , Reproductibilité des résultats , Suidae , Maladies des porcs/diagnosticRésumé
Objective to evaluate the prevalence of Staphylococcus aureus nasal colonization in renal transplant patients and to identify the related risk factors. Method Swabs were used to collect nasal samples from 160 patients who had undergone a transplant within the previous year at the Kidney and Hypertension Hospital. The ‘National Committee for Clinical Laboratory Standards’ norms were followed for the collection, isolation, identification and sensitivity measurements. Results There was a 9.4% (15) prevalence of Staphylococcus aureus nasal colonization, of which one (6.7%) was resistant to oxacillin. It was possible to identify as an associated risk factor a wait of more than one year for accessing dialysis prior to the transplant (p=0.029). Conclusion Given the high morbidity and mortality rates that this microorganism causes in the target population, other studies should be carried out, and pre- and post-transplant screening should occur in order to develop strategies that improve the prevention and control of the spread of Staphylococcus aureus. .
Objetivo Evaluar la prevalencia de la colonización nasal por Staphylococcus aureus en pacientes transplantados renales e identificar los factores de riesgo relacionados. Método Fueron recogidas muestras nasales por medio de swabs de 160 pacientes con hasta un año de hecho el transplante en el Hospital del Riñón e Hipertensión. La recolección, el aislamiento, la identificación y el perfil de sensibilidad fueron llevados a cabo según las normas del National Committee for Clinical Laboratory Standards. Resultados La prevalencia de colonización nasal por Staphylococcus aureus fue del 9,4% (15), siendo uno resistente a la oxacilina (6,7%). Fue posible identificar como factor de riesgo asociado el tiempo de acceso para diálisis mayor de un año (p=0,029) previo al transplante. Conclusión En virtud de la elevada morbilidad y mortalidad causada por ese microrganismo en dicha población, se hace necesaria la realización de otros estudios, adoptándose el screening en los períodos pre y post transplante a fin de definir las estrategias de prevención y el control de la diseminación del Staphylococcus aureus. .
Objetivo Avaliar a prevalência da colonização nasal por Staphylococcus aureus em pacientes transplantados renais e identificar os fatores de risco relacionados. Método Foram coletadas amostras nasais por meio de swabs de 160 pacientes com até um ano de transplante realizado no Hospital do Rim e Hipertensão. A coleta, isolamento, identificação e o perfil de sensibilidade foram realizados segundo as normas do National Committee for Clinical Laboratory Standards. Resultados A prevalência de colonização nasal por Staphylococcus aureus foi de 9,4% (15), sendo um resistente à oxacilina (6,7%). Foi possível identificar como fator de risco associado o tempo de acesso para diálise maior que um ano (p=0,029) prévio ao transplante. Conclusão Devido à elevada morbidade e mortalidade causada por esse microrganismo nessa população, faz-se necessária a realização de outros estudos, adotando o screening nos períodos pré e pós-transplante para definir estratégias de prevenção e controle da disseminação do Staphylococcus aureus. .
Sujets)
Adulte , Femelle , Humains , Mâle , Transplantation rénale , Nez/microbiologie , Staphylococcus aureus/isolement et purification , État de porteur sain , Facteurs de risqueRésumé
OBJECTIVE: to evaluate the prevalence of nasal colonization with Staphylococcus aureus in individuals with HIV/AIDS under inpatient treatment in a teaching hospital in the state of São Paulo (Brazil). METHOD: a cross-sectional study undertaken in two units specialized in attending people living with HIV/AIDS, in the period August 2011 - July 2012. Socio-demographic and clinical data was collected through individual interviews and from the medical records; samples of nasal secretion were collected with Stuart swabs on the first day of inpatient treatment. Ethical aspects were respected. RESULT: of the 229 individuals with HIV/AIDS hospitalized in this period, 169 participated in the study, with Staphylococcus aureus being identified in the culture tests of 46 (27.2%) of the individuals, resistance to oxacillin being evidenced in 10 (21.8%) participants. CONCLUSION: the results of the research indicate that the prevalence of colonization with Staphylococcus aureus in individuals with HIV/AIDS in the specialized units was considered relevant, possibly contributing to future investigations and, moreover, to the implementation of measures to prevent and control this pathogen in this population. .
OBJETIVO: avaliar a prevalência da colonização nasal por Staphylococcus aureus em indivíduos com HIV/Aids internados em um hospital-escola do Estado de São Paulo (Brasil). MÉTODO: estudo de corte transversal, realizado em duas unidades especializadas no atendimento a pessoas que vivem com HIV/ Aids, no período de agosto 2011 a julho 2012. Foram coletados dados sociodemográficos e clínicos, por entrevista individual e prontuário; as amostras de secreção nasal foram coletadas por meio de swab Stuart no primeiro dia de internação. Os aspectos éticos foram contemplados. RESULTADOS: dos 229 indivíduos com HIV/Aids internados no período, 169 participaram do estudo, sendo identificado Staphylococcus aureus nos exames de cultura de 46 (27,2%) dos indivíduos, evidenciando-se resistência à oxacilina em 10 (21,8%) participantes. CONCLUSÃO: os resultados da pesquisa apontam que a prevalência da colonização por Staphylococcus aureus em indivíduos com HIV/Aids internados nas unidades especializadas foi considerada relevante, podendo contribuir para novas investigações e, ainda, para implementar medidas de prevenção e de controle desse patógeno nessa população. .
OBJETIVO: evaluar la prevalencia de la colonización nasal por Staphylococcus aureus en individuos con VIH/sida internados en un hospital escuela del Estado de São Paulo (Brasil). MÉTODO: estudio trasversal, desarrollado en dos unidades especializadas en la atención a personas que viven con VIH/ sida, en el período de agosto del 2011 a julio del 2012. Fueron recolectados datos sociodemográficos y clínicos, mediante entrevista individual y archivo; las muestras de secreción nasal fueron recolectadas mediante Swab Stuart en el primer día de internación. Los aspectos éticos fueron contemplados. RESULTADOS: de los 229 individuos con VIH/sida internados en el período, 169 participaron del estudio, siendo identificado Staphylococcus aureus en las pruebas de cultura de 46 (27,2%) de los individuos, evidenciándose resistencia a la oxacilina en 10 (21,8%) participantes. CONCLUSIÓN: los resultados de la investigación indican que la prevalencia de la colonización por Staphylococcus aureus en individuos con VIH/sida internados en las unidades especializadas fue considerada relevante y puede contribuir a otras investigaciones y, además, para implementar medidas de prevención y de control de ese patógeno en esa población. .
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Adulte , Femelle , Humains , Mâle , Adulte d'âge moyen , Jeune adulte , Infections à VIH/microbiologie , Nez/microbiologie , Staphylococcus aureus/isolement et purification , Syndrome d'immunodéficience acquise/microbiologie , Brésil , Études transversales , Hôpitaux d'enseignement , Infections à staphylocoquesRésumé
We present a case of nasal tuberculosis, a rare presentation of extrapulmonary tuberculosis. This report emphasizes how nasal tuberculosis can mimic other granulomatous disease and place a major challenge in its diagnosis and treatment
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Humains , Femelle , Maladies du nez/microbiologie , Mycobacterium tuberculosis , Nez/microbiologieRésumé
To compare the BD GeneOhm Methicillin Resistant Staphylococcus aureus [MRSA] Achromopeptidase [ACP] polymerase chain reaction [PCR] assay with the culture method for the detection of MRSA colonization. One hundred and two patients were admitted to the Intensive Care Unit in King Khalid Hospital, Najran, Kingdom of Saudi Arabia from July 2010 to February 2011. Separate swabs from the nose, axilla, and groin of each patient were processed by the culture method [sheep blood agar plate and mannitol salt agar plate] and BD GeneOhm MRSA ACP assay. Of the 287 samples, 62 [21.6%] were MRSA positive by the PCR assay and 26 [9%] were MRSA positive by the culture method. The PCR method showed 88.4% sensitivity and 98.6% negative predictive value. The number of MRSA-PCR positive groin specimens was nearly the same as nasal specimens. The PCR method gave positive results in 22.5% of patients by nasal specimens, 27.5% of patients by nasal and groin specimens, and 30.4% of patients by nasal, groin, and axilla specimens. The PCR method detected 30.4% of patients as MRSA positive while the culture method detected 19.6% of patients as positive for MRSA. The BD GeneOhm MRSA ACP assay has high sensitivity and NPV and hence is a useful screening method to exclude patients who are not colonized with MRSA
Sujets)
Humains , Staphylococcus aureus résistant à la méticilline/effets des médicaments et des substances chimiques , Serine endopeptidases , Nez/microbiologie , Aine/microbiologie , Aisselle/microbiologieRésumé
Staphylococcus aureus [SA] may cause infection in all body organs. Many personnel and patients in hospitals may become carriers of this species. The aim of this study was to investigate relative frequency of SA and its resistance to Methicillin. A couple of swabs were taken from nose and nails of 151 personnels working in operation room of Shahid Sadoughi Hospital in Yazd. Samples were inoculated into Mannitol salt agar medium and S. aureus colonies were antibiogramed to determine the rate of resistance to methicillin. Statistical analyses were performed by chi-square and Fishers' exact test. Overall prevalence of SA was 35.09%[19.2% and 15.9% in noses and nails, respectively]. Prevalence of methicillin-resistant SA [MRSA] was 11.92%[5.3% and 6.6% in noses and nails, respectively]. Surgeons had the highest, and workers the lowest prevalence of nasal SA carrier rate. In contrast, the nails of servants had the highest, and surgeons the lowest SA carrier rate. No significant difference was found between carrier rate and age, sex and duration of employment. But a meaningful relation was found between type of job and MRSA in both noses and nails. All of the MRSA isolates were sensitive to vancomycin. Since employees of operation room are continuously working with patients undergone operation, screening both the personnel and patients to determine the rate of carriage, preventing transfusions of fore mentioned bacterium is necessary and highly recommended
Sujets)
Humains , Staphylococcus aureus résistant à la méticilline , Personnel de santé , Prévalence , État de porteur sain , Blocs opératoires , Nez/microbiologie , Ongles/microbiologie , Vancomycine , HôpitauxRésumé
The prevalence of methicillin resistant Staphylococcus aureus [MRSA] and methicillin sensitive Staphylococcus aureus [MSSA] carriage among poultry and poultry farmers in Malaysia is largely unknown. In the current investigation, chickens and chicken farmers from 30 chicken farms were screened for MRSA and S. aureus carriage. The genetic characteristics of the isolates were determined through multi locus sequence typing [MLST], Staphylococcus protein A [spa] typing and virulent gene profiling. The outcome of the study showed lack of MRSA and extremely low S. aureus prevalence [n=7 of 503, 1.4%] among chicken flocks and the poultry farmers in Malaysia. Staphylococcus aureus isolates belonged to 4 sequence types [ST]: ST97 [spa type t359], ST1179 [t359], ST 692 [t2247] and ST188 [t189]. It can be concluded that MRSA/MSSA prevalence is very low among chicken and chicken farmers, human and chicken cross transmission of S. aureus does not seem to be a threat in Malaysia
Sujets)
Humains , Animaux , Nez/microbiologie , Poulets , Staphylococcus aureus , PrévalenceRésumé
This study aimed to investigate whether CHROMagar Acinetobacter medium (CHROMagar, France) in combination with an antimicrobial supplement (modified CHROMagar Acinetobacter; CHROMagar, France) can be used for detecting and isolating multidrug-resistant Acinetobacter species (MRA) in nasal and rectal surveillance cultures. Nasal and rectal swab samples were collected from patients in an intensive care unit at a teaching hospital. The samples were used to inoculate modified CHROMagar Acinetobacter plates, which were examined after 24 and 48 hr of incubation at 37degrees C. Their susceptibility against the antimicrobial agents meropenem, imipenem, ciprofloxacin, and amikacin was analyzed using the Etest (bioMerieux, France). A total of 406 paired samples (406 nasal swabs and 406 rectal swabs) were obtained from 226 patients, and 120 samples (28 nasal and 28 rectal cultures, 47 nasal cultures only, and 17 rectal cultures only) yielded MRA. Seventy-five MRA isolates (18.5%) were recovered from the 406 nasal samples, and 45 MRA isolates (11.1%) were recovered from the 406 rectal samples. Of the 120 MRA isolates, 3 (2.5%) were detected only after 48 hr of incubation. The use of modified CHROMagar Acinetobacter together with nasal and rectal swabs and 1-day incubation is an effective surveillance tool for detecting MRA colonization.
Sujets)
Humains , Acinetobacter/effets des médicaments et des substances chimiques , Infections à Acinetobacter/diagnostic , Antibactériens/pharmacologie , Multirésistance bactérienne aux médicaments/effets des médicaments et des substances chimiques , Unités de soins intensifs , Tests de sensibilité microbienne , Nez/microbiologie , Trousses de réactifs pour diagnostic , Rectum/microbiologieRésumé
This study aimed to investigate whether CHROMagar Acinetobacter medium (CHROMagar, France) in combination with an antimicrobial supplement (modified CHROMagar Acinetobacter; CHROMagar, France) can be used for detecting and isolating multidrug-resistant Acinetobacter species (MRA) in nasal and rectal surveillance cultures. Nasal and rectal swab samples were collected from patients in an intensive care unit at a teaching hospital. The samples were used to inoculate modified CHROMagar Acinetobacter plates, which were examined after 24 and 48 hr of incubation at 37degrees C. Their susceptibility against the antimicrobial agents meropenem, imipenem, ciprofloxacin, and amikacin was analyzed using the Etest (bioMerieux, France). A total of 406 paired samples (406 nasal swabs and 406 rectal swabs) were obtained from 226 patients, and 120 samples (28 nasal and 28 rectal cultures, 47 nasal cultures only, and 17 rectal cultures only) yielded MRA. Seventy-five MRA isolates (18.5%) were recovered from the 406 nasal samples, and 45 MRA isolates (11.1%) were recovered from the 406 rectal samples. Of the 120 MRA isolates, 3 (2.5%) were detected only after 48 hr of incubation. The use of modified CHROMagar Acinetobacter together with nasal and rectal swabs and 1-day incubation is an effective surveillance tool for detecting MRA colonization.
Sujets)
Humains , Acinetobacter/effets des médicaments et des substances chimiques , Infections à Acinetobacter/diagnostic , Antibactériens/pharmacologie , Multirésistance bactérienne aux médicaments/effets des médicaments et des substances chimiques , Unités de soins intensifs , Tests de sensibilité microbienne , Nez/microbiologie , Trousses de réactifs pour diagnostic , Rectum/microbiologieRésumé
Pneumococcal meningitis is a life-threatening disease characterized by an acute purulent infection affecting piamater, arachnoid and the subarachnoid space. The intense inflammatory host's response is potentially fatal and contributes to the neurological sequelae. Streptococcus pneumoniae colonizes the nasopharynx, followed by bacteremia, microbial invasion and blood-brain barrier traversal. S. pneumoniae is recognized by antigen-presenting cells through the binding of Toll-like receptors inducing the activation of factor nuclear kappa B or mitogen-activated protein kinase pathways and subsequent up-regulation of lymphocyte populations and expression of numerous proteins involved in inflammation and immune response. Many brain cells can produce cytokines, chemokines and others pro-inflammatory molecules in response to bacteria stimuli, as consequence, polymorphonuclear are attracted, activated and released in large amounts of superoxide anion and nitric oxide, leading to the peroxynitrite formation, generating oxidative stress. This cascade leads to lipid peroxidation, mitochondrial damage, blood-brain barrier breakdown contributing to cell injury during pneumococcal meningitis.
A meningite pneumocócica é doença potencialmente fatal caracterizada por infecção aguda purulenta que afeta a pia-máter, a aracnoide e o espaço subaracnoide. A resposta inflamatória do hospedeiro é potencialmente fatal e contribui para as sequelas neurológicas. O processo inicia-se com a colonização da nasofaringe pelo Streptococcus pneumoniae, seguida de invasão, bacteremia e passagem através da barreira hematoencefálica. O S. pneumoniae é reconhecido por células apresentadoras de antígenos através da ligação aos receptores Toll-like. Isto induz a ativação do fator nuclear kappa B ou proteína quinase ativada por mitógenos. Muitas células cerebrais também podem produzir citocinas, quimiocinas e outras moléculas pró-inflamatórias em resposta aos estímulos bacterianos. Como consequência, são atraídos polimorfonucleares, ocorrendo a liberação de grandes quantidades de ânion superóxido e óxido nítrico, o que leva à formação de peroxinitrito e ocasiona o estresse oxidativo. Esta cascata pró-inflamatória leva à peroxidação lipídica, a danos mitocondriais e à ruptura da barreira hematoencefálica, contribuindo para o dano celular em meningite pneumocócica.
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Humains , Méningite à pneumocoques , Maladie aigüe , Hormones corticosurrénaliennes/usage thérapeutique , Cytokines/métabolisme , Matrix metalloproteinases/métabolisme , Méningite à pneumocoques/traitement médicamenteux , Méningite à pneumocoques/immunologie , Méningite à pneumocoques/microbiologie , Méningite à pneumocoques/physiopathologie , Nez/microbiologie , Stress oxydatif/physiologie , Streptococcus pneumoniaeRésumé
INTRODUCCIÓN: La correcta manipulación de los alimentos es indispensable para proteger nuestra salud; sin embargo, las enfermedades transmitidas por alimentos son bastante frecuentes, siendo el Staphylococcus aureus uno de los agentes causales más comunes. OBJETIVO: Determinar la prevalencia de portación de nasal de Staphylococcus aureus en manipuladores de alimentos del Mercado Nº4 de Asunción - Paraguay, y evaluar su susceptibilidad al antibiótico oxacilina. MATERIAL Y MÉTODO: Estudio observacional, descriptivo y de corte transversal, con componentes analíticos. Se realizaron hisopados nasales en una muestra compuesta por 105 manipuladores de alimentos en el Mercado Nº4 de Asunción - Paraguay con el fin de detectar la portación nasal de Staphylococcus aureus y sus sensibilidad a la oxacilina. También se determinó la asociación entre el sexo y la portación nasal de Staphylococcus aureus mediante la prueba de X2 (Chi cuadrado) con un nivel de significación de 0,05. RESULTADOS: Staphylococcus aureus fue aislado de las muestras nasales provenientes de 33,3 por ciento de los manipuladores de alimentos estudiados. El estudio de susceptibilidad a antibióticos mostró que 88,6 por ciento fueron sensibles a oxacilina, con 5,7 por ciento de sensibilidad intermedia y 5,7 por ciento de resistencia. No se observó asociación entre sexo y portación nasal de Staphylococcus aureus: Prevalencia Relativa =1,23 (Intervalo de Confianza del 95 por ciento: 0,45 1,99; valor p=0,9). DISCUSIÓN: Los resultados de nuestro estudio revelaron una portación nasal de Staphylococcus aureus similar a la comunicada por otros trabajos científicos. Estos resultados confirman la necesidad de educación y programas de capacitación sobre seguridad alimentaria dirigida a manipuladores de alimentos.
INTRODUCTION: Proper food handling is essential to protect our health. However food-borne diseases are common, Staphylococcus aureus being one of the most common causative agents. OBJECTIVE: Determine the prevalence of nasal carriage of Staphylococcus aureus in food handlers of Market No. 4 in Asunción - Paraguay, and assess their susceptibility to oxacillin. MATERIAL AND METHOD: Observational, cross-sectional, descriptive study with analytical components. Nasal swabs were performed on a sample of 105 food handlers in the No. 4 market in order to detect nasal carriage of Staphylococcus aureus and their susceptibility to oxacillin. We also determined the association between sex and nasal carriage of Staphylococcus aureus by the X2 test (Chi square) with a significance level of 0.05. RESULTS: Staphylococcus aureus was isolated from nasal swabs from 33.3 percent samples of food handlers studied. The antibiotic susceptibility study showed that 88.6 percent were susceptible to oxacillin, with 5.7 percent sensitivity and 5.7 percent intermediate resistance. There was no association between gender and nasal carriage of Staphylococcus aureus: Relative Prevalence = 1.23 (95 percent of Confidence Interval: 0.45 to 1.99, p value = 0.9). DISCUSSION: The results of our study revealed a Staphylococcus aureus nasal carriage similar to that reported by other scientific studies. These results confirm the need for education and training programs focused on food safety for food handlers.
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Humains , Mâle , Adulte , Femelle , Manipulation des aliments , Infections à staphylocoques/épidémiologie , Nez/microbiologie , Staphylococcus aureus/isolement et purification , Commerce , Études transversales , Hygiène , Résistance à la méticilline , Oxacilline , Paraguay , Prévalence , État de porteur sain/épidémiologie , État de porteur sain/microbiologie , Répartition par sexe , Toxi-infection alimentaire à staphylocoquesRésumé
To study the prevalence of virulence factors such as Biofilm and Beta-lactamase in Staphylococcus isolates residing in nasal and throat mucosa in healthy volunteers. Nasal and throat swabs were taken from 100 healthy volunteers at Gulf Medical University and Gulf Medical College Hospital, Ajman, UAE, and cultured for Staphylococcus isolates on appropriate culture media. The isolate were classified as Staphylococcus aureus or Coagulase Negative Staphylococcus [CoNS] based on the growth characteristics on Mannitol Salt Agar and standard tube coagulase test. They were further tested for Biofilm production by Christensen's tissue culture plate and Congo red agar methods. The positive samples were identified for beta-lactamase by iodometric tube method. Of the 100 Staphylococcus isolates, 41 were Staphylococcus aureus of which 25 [61%] were positive for biofilm production whereas 19 [46.3%] were Beta-lactamase positive. Of the 16 [39%] biofilm negative Staphylococcus aureus isolates, 13 [31.7%] were Beta-lactamase positive. Among the 59 CoNS isolates, 38 [64.4%] were positive for biofilm production and 18[30.5%] were Beta-lactamase positive. Twenty one CoNS samples [35.5%] were negative for both biofilm and Beta-lactamase production. Biofilm production in Staphylococcus aureus and CoNS did not show any significant difference [61% and 64.4%]. Predominance of Staphylococcal isolation was in males between the age group of <20 years, mostly from the nasal site. Biofilm-producing Staphylococcus appear to inhabit the normal flora of the nasal and throat mucosa of healthy individuals. Beta-lactamase production was found to be higher in Staphylococcus aureus positive for biofilm producers as compared to CoNS. Transmission of these biofilm producers with drug resistance factors from the healthy individuals to those at risk, like patients on long term catheterization or with indwelling devices need to be considered
Sujets)
Humains , Mâle , Femelle , /enzymologie , bêta-Lactamases/biosynthèse , Staphylococcus aureus/effets des médicaments et des substances chimiques , Prévalence , Nez/microbiologie , Volontaires sains , Pharynx/microbiologie , Systèmes d'entrée des ordonnances médicales , BiofilmsRésumé
Early isolation of patients possibly colonized by multi-resistant microorganisms can minimize their spread, reducing cases of hospital infection and the related costs. This study aimed to identify the sensitivity and specificity of the criteria for isolation of patients admitted to a specialized cancer hospital. Cross-sectional study with a population of 61 patients coming from other hospitals who were admitted to the hospital between March 1st and August 31th, 2009. At the moment of admission, a data collection instrument was filled out and nasal and anal swabs were collected for microbiological culture. Of the 56 patients who met the isolation criteria, 30 (49.2 percent) presented positive cultures for multi-resistant microorganisms and methicillin-resistant Staphylococcus aureus was the most frequently identified microorganism. Most patients colonized by multi-resistant microorganisms were isolated at the moment of admission. The sensitivity of the isolation criteria was 90 percent and the specificity was 6.5 percent.
O isolamento precoce de pacientes, possivelmente colonizados por microrganismos multirresistentes, pode minimizar sua disseminação, reduzindo os casos de infecção hospitalar e os custos associados. O objetivo deste estudo foi identificar a sensibilidade e especificidade dos critérios para isolamento de pacientes admitidos num hospital especializado em oncologia. Como método, usou-se o estudo transversal. A população foi composta por 61 pacientes, admitidos no período de 1º março a 31 de agosto de 2009, e procedentes de outros hospitais. Foi preenchido instrumento de coleta de dados no momento da admissão e colhidas amostras da região nasal e anal para cultura microbiológica. Os resultados mostraram que, dos 56 pacientes que preencheram os critérios de isolamento, 30 (49,2 por cento) tiveram culturas positivas para microrganismos multirresistentes e o Staphylococcus aureus resistente à oxacilina foi o mais frequentemente identificado. A maioria dos pacientes colonizados foi isolada no momento da admissão. Conclui-se que a sensibilidade dos critérios para isolamento foi de 90 por cento e a especificidade de 6,5 por cento.
El aislamiento precoz de pacientes posiblemente colonizados por microorganismos multirresistentes puede minimizar su diseminación, reduciendo los casos de infección hospitalaria y los costos asociados. El objetivo de este estudio fue identificar la sensibilidad y especificidad de los criterios para aislamiento de pacientes admitidos en un hospital especializado en oncología. Se trata de un estudio transversal cuya población fue compuesta por 61 pacientes admitidos en el período de 01 marzo a 31 de agosto de 2009 y procedentes de otros hospitales. Fue llenado un instrumento de recolección de datos en el momento de la admisión y recogidas muestras de la región nasal y anal para cultura microbiológica. De los 56 pacientes que llenaron los criterios de aislamiento, 30(49,2 por ciento) tuvieron culturas positivas para microorganismos multirresistentes y el Staphylococcus aureus resistente a la oxacilina fue el más frecuentemente identificado. La mayoría de los pacientes colonizados fue aislada en el momento de la admisión. La sensibilidad de los criterios para aislamiento fue de 90 por ciento y la especificidad de 6,5 por ciento.