摘要
Conocer el rol del medio ambiente es fundamental para evitar las infecciones intra-hospitalarias. Con ese objetivo, se planteó evaluar la prevalencia de contaminación ambiental por microorganismos multirresistentes (MMR) antes y después de la limpieza terminal de habitaciones de pacientes colonizados y establecer si la aparatología de uso común actuaba como reservorio de estos en la unidad de cuidados intensivos (UTI). Se obtuvieron muestras ambientales de las habitaciones, 48 h posteriores a la detección de colonización y luego de las limpiezas. Los resultados mostraron que luego de ambos procedimientos de limpieza se logró reducir de 28,2% a 2,6% la contaminación por Acinetobacter spp. multirresistente (AMR). También, se tomaron muestras de aparatología de uso común encontrándose entre 1,8 y 5,4% de contaminación por MMR. La limpieza y desinfección reducen significativamente la contaminación ambiental. Sin embargo, la colonización de equipos por MMR y el incumplimiento de precauciones universales representan una posibilidad de transmisión cruzada.
It is essential to understand the role of the environment in order to avoid intrahospital infections. To achieve this objective, this research proposes to assess the prevalence of the environmental contamination caused by multi-resistant microorganisms (MRM) before and after terminal disinfection in rooms with colonized patients, but also to establish whether the commonly used device acts as a reservoir of those micro-organisms in an intensive care unit (ICU). Environmental samples were obtained from the rooms, 48 hours after detecting colonization and also after the first and second final cleaning. The results showed that after both procedures, there was a reduction from 28.2% to 2.6% of contamination caused by multi-resistant Acinetobacter spp. (AMR). Samples from appliances and supplies were taken as well, in which case, between 1.8 and 5.4% of contamination levels induced by MMR were found. Cleaning and disinfecting significantly reduce environmental contamination. However, both MMR bacterial colonization and the lack of universal precautions enforcement represent a possibility of cross-transmission.
É essencial conhecer o papel do meio ambiente para evitar as infecções intra-hospitalares. Com esse objetivo, planejou-se avaliar a prevalência de contaminação ambiental por microorganismos multirresistentes (MMR) antes e depois da limpeza final dos quartos de pacientes colonizados e estabelecer se os aparelhos de uso comum atuavam como um reservatório deles na unidade de terapia intensiva (UTI). Obtiveram-se amostras ambientais dos quartos 48 horas após a detecção da colonização e logo após as limpezas finais. Os resultados mostraram que depois dos dois procedimentos de limpeza se obteve uma redução de 28,2% para 2,6% da contaminação por Acinetobacter spp. multirresistente (AMR). Foram obtidas também amostras de aparelhos de uso comum onde se encontraram entre 1,8% e 5,4% de contaminação por MMR. A limpeza e a desinfecção reduzem significativamente a contaminação ambiental. Contudo, a colonização de equipamentos por MMR e o não cumprimento de providências universais representam uma possibilidade de transmissão cruzada.
Subject(s)
Humans , Acinetobacter , Acinetobacter/pathogenicity , Disinfection , Environmental Pollution , Environmental Pollution/prevention & control , Housekeeping, Hospital , Housekeeping, Hospital/ethics , Intensive Care Units , Research , Role , Patients' Rooms , Environmental Monitoring/methods , Prevalence , Environment , Housekeeping, Hospital/standards , Infections , Methods摘要
Objetivo: Buscou-se no presente trabalho identificar os principais patógenos envolvidos em infecções em pacientes queimados, bem como enfatizar a relevância do diagnóstico adequado para o tratamento de sepse. Método: Para a realização do presente trabalho, foi feito levantamento bibliográfico de caráter exploratório e obtidos 33 estudos relevantes. A coleta de informações ocorreu nos meses de março a novembro de 2016. Resultados: Dentre os principais patógenos presentes em queimados, que podem gerar quadro de sepse, estão Pseudomonas aeruginosa, Staphylococcus aureus, Acinetobacter sp, Candida albicans e Proteus sp. Esses podem, ou não, estar relacionados à própria microbiota do paciente. O processo de infecção, com perda da primeira linha de defesa imunológica, deixa o organismo suscetível à entrada e instalação de microrganismos. O tratamento da sepse depende de fatores relevantes, que incluem a gravidade da lesão e o agente causador da infecção. Conclusão: O risco de ocorrência de sepse, associada às infecções em queimados nas unidades de tratamento intensivo, pode ser reduzido com o diagnóstico adequado e acompanhamento do paciente.
Objective: This article aimed to identify the main pathogens involved in infections in burned patients, as well as to emphasize the relevance of the appropriate diagnosis for the treatment of sepsis. Methods: For the accomplishment of the present work, it was carried out a bibliographic survey of exploratory character and 33 relevant studies were obtained. Data collection was carried out from March to November 2016. Results: Among the main pathogens present in burnt patient related with sepsis are Pseudomonas aeruginosa, Staphylococcus aureus, Acinetobacter sp, Candida albicans and Proteus sp. These pathogens may or may not be related to the patients microbiota. The infection process, with loss of the first line of immune defense, leaves the organism susceptible to the entry and installation of microorganisms. Treatment of sepsis depends on relevant factors including the severity of the lesion and the agent of the infection. Conclusion: The risk associated with sepsis in burned patients may be reduced with appropriate diagnosis and monitoring.
Objetivo: El objetivo de este artículo fue identificar los principales patógenos asociados en infecciones en pacientes com quemaduras, así como enfatizar la relevancia del diagnóstico adecuado para el tratamiento de la sepsis. Métodos: Para el desarrollo del presente trabajo, se realizó una búsqueda bibliográfica de caracter exploratório, siendo considerados relevantes 33 estudios. La búsqueda de datos se realizó de marzo a noviembre de 2016. Resultados: Entre los principales patógenos presentes en pacientes quemados relacionados con la sepsis se destacaron Pseudomonas aeruginosa, Staphylococcus aureus, Acinetobacter sp, Candida albicans y Proteus sp. Estos patógenos pueden o no estar relacionados con la microbiota del paciente. El proceso de infección, con la pérdida de la primera línea de defensa inmunológica, deja el organismo susceptible a la entrada e instalación de microorganismos. El tratamiento de la sepsis depende de factores relevantes, incluyendo la gravedad de la lesión y el agente de la infección. Conclusión: El riesgo asociado con la sepsis en pacientes quemados puede reducirse con un diagnóstico y seguimiento adecuados.
Subject(s)
Humans , Burn Units , Burns , Sepsis/diagnosis , Sepsis/therapy , Proteus/pathogenicity , Pseudomonas aeruginosa/pathogenicity , Staphylococcus aureus/pathogenicity , Acinetobacter/pathogenicity , Candida albicans/pathogenicitySubject(s)
Acinetobacter/enzymology , Acinetobacter/pathogenicity , Bacterial Proteins/genetics , Bacterial Proteins/isolation & purification , Cefoxitin/therapeutic use , Cross Infection/drug therapy , Cross Infection/microbiology , Disk Diffusion Antimicrobial Tests , Drug Resistance, Bacterial , Humans , beta-Lactamases/genetics , beta-Lactamases/isolation & purification摘要
The study on microbial populations is a suitable tool to understand and apply control methods to improve the sanitary level of production in fish breeding and rearing centers, ensure health of sturgeon fingerlings at the time of their release into the rivers and also in the conversation and restoration of these valuable stocks in the Caspian Sea, Iran. A laboratory research based on Austin methods [Austin, B., Austin, D.A 1993] was conducted for bacterial study on 3 sturgeon species naming A. persicus, A. stellatus and A. nudiventris during different growth stages. Bacterial flora of Acinetobacter, Moraxella, Aeromonas, Vibrio, Edwardsiella, Staphylococcus, Proteus, Yersinia, Pseudomonas and Plesiomonas were determined. The factors which may induce changes in bacterial population during different stages of life are the followings: quality of water in rearing ponds, different conditions for growth stages, suitable time for colonization of bacterial flora in rearing pond, water temperature increase in fingerlings size and feeding condition
Subject(s)
Animals , Fresh Water/microbiology , Temperature , Acinetobacter/pathogenicity , Moraxella/pathogenicity摘要
El trabajo comportamiento de acinetobacter en los procesos infecciosos de pacientes ingresados al HEALF de enero de 2004- diciembre de 2005, se realizó con el objetivo de conocer el comportamiento de esta bacteria en nuestro medio ya que el acinetobacter ha surgido como un importante microorganismo a nivel intrahospitalario y uno de los mayores problemas de la infecciones producidas por esta bacteria es su tratamiento, por su amplia multiresistencia y por las pocas alternativas terapéuticas disponibles en la actualidad. Dicho estudio es descriptivo, de serie de casos. Para alcanzar este objetivo se estudiaron 452 pacientes a los que se aisló 528 Acinetobacter. Los procesos infewcciosos más frecuentes fueron: Sepsis de Herida Quirúrgica, Neumonías y Traqueóbronquitis. Los servicios más afectados fueron: Medicina Interna y de esta, la sala de UCI (Unidad de cuidados intensivos), Neurocirugía, principalmente lka sala de Neurocirugía Intermedios y cirugía plástica principalmente la sala de quemados. Según los resultados de Antibiogrma se encontró un alto grado de resistencia de la bacteria a los antibióticos disponibles en la Lista Básica de Medicamentos como son: Ceftriazona, Ampicilina, Amikacina, Ceftazidima y en menor grado de resistencia a los Carbapemenes (Imipenem, Meropenem)...>
Subject(s)
Acinetobacter/isolation & purification , Acinetobacter/classification , Acinetobacter/pathogenicity , Cross Infection , Acinetobacter Infections/classification , Acinetobacter Infections/diagnosis , Acinetobacter Infections/epidemiology , Acinetobacter Infections/etiology , Acinetobacter Infections/pathology , Acinetobacter Infections/drug therapy , Acinetobacter Infections/transmission , Gram-Negative Bacterial Infections/classification , Gram-Negative Bacterial Infections/epidemiology , Gram-Negative Bacterial Infections/pathology , Nicaragua摘要
Antecedentes: Acinetobacter sp un cocobacilo gramnegativo no fermentador de poca virulencia pero que en pacientes hospitalizados susceptibles es una causa importante de morbilidad y mortalidad, especialmente en la unidades de cuidado intensivo (UCI). Objetivo: determinar las características de los pacientes infectados por Acinetobacter sp en la UCI del Hospital Universitario Erasmo Meoz de Cúcuta (HUEM), Colombia. Materiales y Métodos: estudio retrospectivo descriptivo de los pacientes que tuvieron cultivo positivo para Acinetobacter sp que ingresaron a la UCI del HUEM entre enero de 2002 y junio de 2003. Se recolectaron datos sociodemográficos, del diagnóstico y manejo instaurado, y del reporte del cultivo del laboratorio. Resultados: durante el período analizado se realizaron 247 cultivos, de los cuales 25 fueron positivos para Acinetobacter sp (10.1 por ciento). La incidencia de infección fue del 12.5 por ciento en el 2002 y del 7.2 por ciento en el 2003. De 22 pacientes analizados, 21 (95.5 por ciento) sufrieron infección nosocomial. La resistencia antibiótica fue alta; solo los carbapenem y el minociclino tienen resistencia menor al 70 por ciento. Conclusiones: la incidencia de infección por Acinetobacter sp y la resistencia antibiótica es alta en la UCI del HUEM. Esto lleva a analizar y mejorar la normas de bioseguridad, junto con la estandarización de protocolos de diagnóstico y manejo de pacientes susceptibles para desarrollar infección nosocomial
Subject(s)
Acinetobacter/pathogenicity , Acinetobacter Infections , Cross Infection , Critical Care摘要
Background: Acinetobacter baumannii is an important etiological agent causing nosocomial infections. High level of resistance for different kind of antimicrobials has been observed, including ß-lactam antibiotics. This feature, chromosomal or plasmid encoded, has been associated to integrons harbouring antibiotic resistance gene cassettes. Aims: To investigate the presence of integrons among clinical isolates resistant to third generation cephalosporins (3GC). Material and methods: One hundred A. baumannii strains isolated from several Chilean hospitals were included in this study. Minimal inhibitory concentrations (MIC) of 3GC by an agar dilution method were carried out. Integrons class 1, 2 and 3 were investigated by colony blot hybridisation and confirmed by PCR. Results: High level of resistance to all assayed 3GC was observed. On the other hand, integrón class 2 was the most prevalent (77 percent of isolates) followed by integron class 1 (52 percent). Forty six percent of isolates hybridised with probes for both of them. However, no positive hybridisation was detected for integron class 3. Conclusions: Nevertheless, most isolates harboured one or both class of integron; there was no direct relationship between the presence of these genetic structures and the resistance to this kind of ß-lactam antibiotics
Subject(s)
Humans , Acinetobacter/genetics , Drug Resistance, Microbial/genetics , Cephalosporin Resistance/genetics , In Vitro Techniques , Acinetobacter/isolation & purification , Acinetobacter/drug effects , Acinetobacter/pathogenicity , DNA Transposable Elements/drug effects , Cross Infection/microbiology , OligonucleotidesSubject(s)
Acinetobacter/drug effects , Acinetobacter/isolation & purification , Acinetobacter/pathogenicity , Drug Resistance, Microbial/immunology , Cross Infection/epidemiology , Cross Infection/microbiology , Pseudomonas aeruginosa/drug effects , Pseudomonas aeruginosa/isolation & purification , Pseudomonas aeruginosa/pathogenicity , Argentina , Microbial Sensitivity Tests摘要
Background: Acinetobacter baumannii is an important nosocomial pathogen whose virulence factors have not been fully elucidated. Aim: To study the adherence and hemagglutinating capacity of several biotypes of Acinetobacter baumannii. Material and methods: Thirty nine strains of Acinetobacter baumannii isolated from hospitalized patients were studied. The adherence of these strains to small pieces of rat tracheal tissue was studied. Additionally, their ability to hemagglutinate human erythrocytes and the effect of D-mannose and D-galactose on the adherence and hemagglutinating capacity was assessed. Transmission electron microscopy of strains was performed looking for the presence of fimbriae. Results: All strains exhibited adherence to tissues. All strains had also D-mannose and D-galactose resistant hemagglutinating ability. Fimbriae were found in Acinetobacter baumannii and E coil cells. Conclusions: Adherence of Acinetobacter baumannii to rat tracheal tissue, apparently not related to the presence of fimbriae, may be a virulence mechanism of this bacterium
Subject(s)
Animals , Rats , Acinetobacter/drug effects , Bacterial Adhesion , Trachea/microbiology , Virulence/drug effects , Acinetobacter/isolation & purification , Acinetobacter/pathogenicity , Rats, Sprague-Dawley/microbiology , Galactose Dehydrogenases/pharmacology , Bacteriological TechniquesSubject(s)
Humans , Acinetobacter/drug effects , Drug Resistance, Microbial , Anti-Bacterial Agents/pharmacology , Skin/parasitology , Acinetobacter/isolation & purification , Acinetobacter/classification , Acinetobacter/pathogenicity , Acinetobacter Infections/drug therapy , Amikacin/pharmacology , Gentamicins/pharmacology , Sulbactam/pharmacology , Bacteriological Techniques摘要
Two hundred and seven patients attended Aim Shams Univesity hospital and suspected to have septicemia were included in the study. Blood cultures were performed to all patients. Forty-two [20%] blood cultures were positive, of which 6 isolates [2.9%] were Acinetobacter species. Acinetobacter thus represents 6 of 42 [14.3%] of all bacteremias. Four of the six isolates were A. baumannii [66.7%] and two cases were A. lwoffii [33.3%]. The isolated Acinetobacter strains were resistant to most of antimicrobial agents. Five strains were sensitive to ampicillin/sulbactam and imipenema. Three strains were sensitive to ciprofloxacin and amikacin and only one was sensitive to tobramycin. We recommended the use of ampicillin/sulbactam or imipenem in treatment of Acinetobacter septicemia however, susceptibility testing should be done to select the best antimicrobial drug for therapy
Subject(s)
Humans , Male , Female , Acinetobacter/pathogenicity , Sepsis/microbiology , Acinetobacter/drug effects , Anti-Infective Agents摘要
Acinetobacter spp. Glucose non-fermenter, Gram negative rods and normal commensal of human sin, are increasingly frequent pathogens for nosocomial infections. The organism is noteworthy because of it's widespread resistance to most available antibiotics and serious outcome. Most reported incidences were hospital acquired infections like infected wounds, ventilator associated pneumonias or chatheter-related infections in critically-ill immuno-compromised patients. Community acquired acinetobacter infections are extremely rare; most reported instances being pneumonias in patients with underlying disease. We report a case of community acquired multi-resistant Acinetobacter septicemia in an apparently immuno-competent patient presenting as ARDS and ending fatally
Subject(s)
Humans , Male , Acinetobacter/pathogenicity , Cross Infection/microbiology , Respiratory Distress SyndromeSubject(s)
Humans , Cross Infection/diagnosis , Pneumonia/diagnosis , Acinetobacter/pathogenicity , Anti-Bacterial Agents/administration & dosage , Enterobacter/pathogenicity , Pneumonia, Staphylococcal/diagnosis , Pneumonia, Staphylococcal/drug therapy , Pneumonia/microbiology , Pneumonia/drug therapy , Pseudomonas aeruginosa/pathogenicity , Risk Factors摘要
Twenty-six neonates were diagnosed to have acinetobacter sepsis during 1986-90, representing 6.5% of all cases of bacteriologically proven sepsis. Of these 19 neonates were low birth weight (LBW) 12 were small for gestational age (SGA). Nineteen neonates had early-onset sepsis. The male to female ratio was 9:17. The hematological profile was suggestive of sepsis in 17 cases. All infants had clinical evidence of multi system infection. Eleven babies died; the cases-fatality rate was 42.3%. Only 15/25 culture isolates were sensitive to gentamicin and resistance to other antibiotics was even more frequent. Acinetobacter was cultured from other sites: eye swabs, skin pustules and umbilical catheter tips. Environmental nursery surveillance cultures done during the study period yielded Acinetobacter once from a crib, but no cases of sepsis occurred around that time. The epidemiological features of this organism illustrate the value of vigilance and precautionary measures.
Subject(s)
Acinetobacter/pathogenicity , Birth Weight , Female , Gentamicins/therapeutic use , Humans , India/epidemiology , Infant, Newborn , Male , Sepsis/drug therapy , Sex Factors摘要
Los objetivos del estudio fueron identificar los germenes mas frecuentes en el liquido amniotico de pacientes sometidas a cesarea y surelación con la integridad de las membranas ovulares. Se realizó un estudio prospectivo de 100 pacientes sometidos a cesarea y su relación con la integridad de las membranas ovulares. se realizó un estudio prospectivo de 100 pacientes sometidas a cesarea seleccionadas por metodo aleatorio simple. La muestra de liquido amniótico fue tomada en forma esteril durante el acto operatorio y cultivada en medios de aerobiosis y anaerobiosis. Se encontro 21 por ciento de cultivos positivos, de los cuales 90 por ciento fueron en pacientes con membranas rotas y 10 por ciento con membranas integras. Los gérmenes encontrados fueron Acinetobacter sp. 38.10 por ciento y Stafilococo aureus 28.57 por ciento. El 52.6 por ciento de cultivos positivos correspondieron a rotura de membranas menor de 6 horas. Concluimos que los gérmenes mas frecuentes aislados de líquido amniotico de pacientes cesareadas son aeróbicos a diferencia de estudios extranjeros. El hallazgo de 52.6 por ciento de cultivos positivos de pacientes con rotura de membranas menor de 6 horas, difiere de los actuales esquemas de administración de antibioticos a partir de las 6 horas. Los casos de cultivos positivos con membranas integras, estarian en relación con otras vías de contaminación de liquido amniotico, que ameritan estudios posteriores
Subject(s)
Cesarean Section/trends , In Vitro Techniques , Amniotic Fluid/microbiology , Staphylococcus aureus/isolation & purification , Staphylococcus aureus/pathogenicity , Acinetobacter/isolation & purification , Acinetobacter/pathogenicity , Fetal Membranes, Premature Rupture/complications , Fetal Membranes, Premature Rupture/microbiology , Escherichia coli/isolation & purification , Escherichia coli/pathogenicity , Extraembryonic Membranes/pathology摘要
Acinetobacter calcoaceticus ssp. anitratus (actualmente denominado Acinetobacter baumanii) es un Bacilo Gram (-) no fermentador, de baja virulencia, considerado un patógeno oportunista especialmente en pacientes hospitalizados. Las manifestaciones clínicas producidas por este microorganismo son diversas, siendo las más importantes por su gravedad las infecciones respiratorias y las bacteremias ya que su letalidad es de un 40%y 50%respectivamente. En el Hospital San Juan de Dios se comenzó a aislar Acinetobacter desde 1988 (3,4%del total de agentes aislados en infecciones intrahospitalarias aumentando a 10,5%en 1989, lo que se mantendría hasta la fecha. La tasa de ataque es variable según los Servicios, siendo la más alta la observada en la Unidad de Cuidados Intensivos (70,9%por 1.000 egresos). La localización de la infección por Acinetobacter también es diferente según los Servicios siendo en UCI más frecuentes las infecciones respiratorias; en Medicina Interna las del aparato respiratorio y las bacteremias y en Cirugía las de heridas operatorias