Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 53
Filtrar
1.
Revista Digital de Postgrado ; 8(3): e167, 2019. graf
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1087875

RESUMO

La utilización de catéter venoso central produce, en ocasiones, infecciones de tipo local o sistémico, como la bacteriemia no complicada o complicada (bacteriemia persistente, tromboflebitis séptica, endocarditis y otras complicaciones metastásicas). En este estudio se dan a conocer las infecciones ocasionadas por el uso de Catéter Venoso Central (CVC), así como los microorganismos presentes en los pacientes. Métodos: La investigación fue de tipo retrospectivo, descriptivo y de corte transversal, con un diseño de investigación no experimental y tuvo la finalidad de conocer, en forma directa, la realidad de la problemática. Las unidades de observación fueron (188) historias clínicas de los pacientes que ingresaron en el servicio de medicina interna en el hospital Miguel Pérez Carreño en el periodo comprendido entre enero y abril de 2017. Resultados: En 30 de los pacientes se realizó el cultivo de la punta del catéter venoso central. En el 67% no hubo crecimiento de microorganismos, mientras que el 33% crecieron microorganismos a las 24 horas. El 80% de las muestras cultivadas reportan la presencia de Cocos Gram positivos. Un 10% reportaron enterobacterias y un 10% reportan levaduras, finalmente con menor frecuencia pseudomona con un 0%. Conclusiones: Solo 78 pacientes ameritaron la colocación de un catéter venoso central, de los cuales se cultivaron 30 puntas de catéter, encontrándose que solo 10 de las puntas de catéteres dieron positivas para infección con crecimiento bacteriano a las 24 horas, siendo los cocos Gram positivos la principal bacteria aislada en los pacientes con CVC seguidos de enterobacterias(AU)


Intravascular catheterization is used for hemodynamic monitoring, hemodialysis, metabolic and nutritional support, fluid administration, chemotherapy and prolonged antibiotic therapy, blood and derivatives, among others. In this study, infections caused by the use of (CVC) central venous catheter are reported, as well as the microorganisms present in patients. Methods: The research was of a retrospective, descriptive and cross-sectional type, with a non-experimental research design and aimed to know, in a direct way, the reality of the problem. The observation units were (188) clinical records of the patients admitted to the internal medicine service at the Miguel Pérez Carreño Hospital in the period between January and April 2017. Results In 30 of the patients, the culture of the tip of the central venous catheter. In 67% there was no growth of microorganisms, while 33% grew microorganisms at 24 hours. 80% of the cultivated samples report the presence of Gram-positive cocci. 10% reported enterobacteria and 10% reported yeast, finally with less frequency pseudomonas with 0%. Conclusions: Only 78 patients required placement of a central venous catheter, of which 30 catheter tips were cultured, finding that only 10 of the catheter tips were positive for infection with bacterial growth at 24 hours, with Gram-positive cocci. the main bacteria isolated in patients with CVCfollowed by enterobacteria(AU)


Assuntos
Humanos , Adolescente , Adulto , Tromboflebite/diagnóstico , Cateterismo Venoso Central/métodos , Cocos Gram-Positivos , Endocardite/diagnóstico , Infecções Relacionadas a Cateter/microbiologia , Cateteres Venosos Centrais/efeitos adversos , Infecções Bacterianas , Registros Médicos/estatística & dados numéricos , Infecção Hospitalar/epidemiologia , Estudos Retrospectivos
3.
Rev. bras. parasitol. vet ; 23(4): 473-480, Oct-Dec/2014. tab
Artigo em Inglês | LILACS | ID: lil-731245

RESUMO

Blood samples were collected from 99 domestic dogs from the urban and rural areas of the Lábrea municipality, state of Amazonas, Brazil. Canine serum samples were tested by immunofluorescence assay against Rickettsia spp., which revealed that only 3.0% (1/33) and 7.6% (5/66) of the dogs from urban and rural areas, respectively, reacted positively to at least one Rickettsia species. DNA was extracted from canine blood and tested by a battery of PCR assays targeting protozoa of the genera Babesia and Hepatozoon, and bacteria of the genera Rickettsia and Ehrlichia and family Anaplasmataceae. All samples were negative in the PCR assays targeting the genera Babesia, Hepatozoon, Ehrlichia and Rickettsia. For Anaplasmataceae, 3% (1/33) and 39.4% (26/66) of the urban and rural dogs, respectively, yielded amplicons that generated DNA sequences 100% identical to the corresponding sequence of Wolbachia endosymbiont of Dirofilaria immitis. Because of these results, all canine DNA samples were further tested in a PCR assay targeting filarial nematodes, which was positive for 18.2% (6/33) and 57.6% (38/66) urban and rural dogs, respectively. Filarial-PCR products generated DNA sequences 100% identical to D. immitis. While tick-borne infections were rare in Lábrea, D. immitis infection rates were among the highest reported in South America.


Amostras de sangue foram coletadas de 99 cães domésticos de áreas urbana e rural do município de Lábrea, estado do Amazonas. Soros caninos foram testados pela técnica de imunofluorescência indireta contra Rickettsia spp., resultando em apenas 3,0% (1/33) e 7,6% (5/66) de cães soropositivos nas áreas urbana e rural, respectivamente. DNA foi extraído do sangue canino e testado por diferentes protocolos da PCR para detecção de protozoários dos gêneros Babesia e Hepatozoon, e bactérias dos gêneros Rickettsia e Ehrlichia e da família Anaplasmataceae. Todas as amostras foram negativas nos protocolos de PCR para os gêneros Babesia, Hepatozoon, Ehrlichia e Rickettsia. Para Anaplasmataceae, 3% (1/33) e 39,4% (26/66) dos cães de áreas urbana e rural, respectivamente, geraram sequências de DNA 100% idênticas ao endosimbionte Wolbachia de Dirofilaria immitis. Posteriormente, as amostras foram testadas pela PCR para nematódeos filarídeos, resultando em 18,2% (6/33) e 57,6% (38/66) de amostras positivas nas áreas urbana e rural, respectivamente. Os produtos geraram sequências de DNA 100% idênticas a D. immitis. Em contraste com várias outras regiões do Brasil, infecções transmitidas por carrapatos foram raras em Lábrea. Por outro lado, as frequências de infecção por D. immitis estiveram entre as mais altas relatadas na América do Sul.


Assuntos
Animais , Meios de Cultura , Catalase/análise , Cocos Gram-Positivos/enzimologia , Cocos Gram-Positivos/isolamento & purificação , Leite/microbiologia , Colistina , Enterococcus/crescimento & desenvolvimento , Enterococcus/isolamento & purificação , Compostos Férricos , Cocos Gram-Positivos/crescimento & desenvolvimento , Lactococcus/crescimento & desenvolvimento , Lactococcus/isolamento & purificação , Ácido Oxolínico , Staphylococcaceae/crescimento & desenvolvimento , Staphylococcaceae/isolamento & purificação , Streptococcaceae/crescimento & desenvolvimento , Streptococcaceae/isolamento & purificação , Streptococcus/crescimento & desenvolvimento , Streptococcus/isolamento & purificação , Tálio
4.
Biomédica (Bogotá) ; 34(supl.1): 191-208, abr. 2014. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-712436

RESUMO

En los últimos años se han desarrollado nuevas alternativas para el tratamiento de infecciones por patógenos Gram positivos multirresistentes, entre los cuales Staphylococcus aureus resistente a la meticilina (SARM) y los enterococos resistentes a la vancomicina (ERV) se consideran un verdadero reto terapéutico, y aunque el uso de la vancomicina en infecciones graves causadas por SARM ha generado serias dudas en los últimos años, continúa siendo escasa la información clínica de respaldo al uso de agentes terapéuticos que la superen en eficacia. El linezolid, la daptomicina y la tigeciclina son agentes que tienen actividad contra los cocos Gram positivos y que fueron aprobados e introducidos en la terapia clínica en la década pasada. Además, se han probado o están en las fases finales de desarrollo otros agentes como las cefalosporinas de última generación (ceftarolina y ceftobiprol). El propósito de esta revisión fue describir las nuevas alternativas terapéuticas, particularmente en la era posterior a la vancomicina, y repasar las características químicas más relevantes de los compuestos y su espectro de actividad, haciendo énfasis en sus mecanismos de acción y resistencia.


New therapeutic alternatives have been developed in the last years for the treatment of multidrug-resistant Gram-positive infections. Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) are considered a therapeutic challenge due to failures and lack of reliable antimicrobial options. Despite concerns related to the use of vancomycin in the treatment of severe MRSA infections in specific clinical scenarios, there is a paucity of solid clinical evidence that support the use of alternative agents (when compared to vancomycin). Linezolid, daptomycin and tigecycline are antibiotics approved in the last decade and newer cephalosporins (such as ceftaroline and ceftobiprole) and novel glycopeptides (dalvavancin, telavancin and oritavancin) have reached clinical approval or are in the late stages of clinical development. This review focuses on discussing these newer antibiotics used in the "post-vancomycin" era with emphasis on relevant chemical characteristics, spectrum of antimicrobial activity, mechanisms of action and resistance, as well as their clinical utility.


Assuntos
Humanos , Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla , Cocos Gram-Positivos/efeitos dos fármacos , Antibacterianos/classificação , Antibacterianos/uso terapêutico , Proteínas de Bactérias/genética , Cefalosporinas/classificação , Cefalosporinas/farmacologia , Daptomicina/farmacologia , Farmacorresistência Bacteriana Múltipla/genética , Farmacorresistência Bacteriana Múltipla/fisiologia , Drogas em Investigação/farmacologia , Genes Bacterianos , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Infecções por Bactérias Gram-Positivas/epidemiologia , Infecções por Bactérias Gram-Positivas/microbiologia , Cocos Gram-Positivos/genética , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Minociclina/análogos & derivados , Minociclina/farmacologia , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Vancomicina/farmacologia
5.
Medicina (B.Aires) ; 72(2): 109-114, abr. 2012. tab
Artigo em Espanhol | LILACS | ID: lil-639660

RESUMO

La endocarditis infecciosa es una enfermedad de baja incidencia que en las últimas décadas mostró modificaciones respecto de su presentación, posibilidad diagnóstica y tratamiento. A pesar de estos avances, la mortalidad hospitalaria sigue siendo muy elevada. Nuestro objetivo fue analizar las características de los pacientes con endocarditis infecciosa activa y su relación con la mortalidad hospitalaria a lo largo de 16 años. Se realizó un registro prospectivo entre 1994 y 2010 de pacientes ingresados con endocarditis. Se analizaron características clínicas, evolución y tratamiento y se registraron los eventos intrahospitalarios. Ingresaron 152 pacientes, 64.5% varones, edad 45 ± 16 años, las causas más frecuentes de cardiopatía de base fueron: congénita 32 (21%) y reumática 20 (13.2%). Los motivos de internación fueron síndrome febril 116 (76.3%) e insuficiencia cardíaca 61 (40.1%). Se identificó el agente infeccioso en 106 (69.7%) de los casos, el más frecuente fue Streptococcus viridans. El ecocardiograma mostró vegetaciones en 123 (80.9%) de los pacientes y 88 (57.8%) presentaron complicaciones durante su internación, siendo la más frecuente la insuficiencia cardíaca. Se indicó tratamiento quirúrgico en 96 (63.1%) de los casos, fundamentalmente por insuficiencia cardíaca en 66. La mortalidad hospitalaria global fue 46 (30.2%). El desarrollo de complicaciones en la internación, la indicación de cirugía y la presencia de insuficiencia cardíaca refractaria al tratamiento fueron predictores independientes de mortalidad hospitalaria, mientras que la presencia de vegetaciones resultó un predictor independiente de mejor supervivencia. La identificación temprana de estos predictores descriptos podría ayudar a mejorar los resultados.


Active infective endocarditis (IE) is a disease of low incidence that has showed changes in presentation, diagnosis and treatment options during the past decades. Despite these advances, mortality remains very high. Our goal was to analyze the characteristics of patients with active IE and their relationship with in-hospital mortality over 16 years. Between 1994 and 2010 we performed a prospective registry of 152 consecutive patients (64.5% male, age 45 ± 16 years) admitted with IE. Clinical characteristics, treatment and inpatient outcomes were analyzed. The most common causes of underlying heart disease were: congenital (21%) and rheumatic fever (13.2%). The reasons for hospitalization were fever (76.3%) and heart failure (40.1%). The infectious agent was identified in 69.7% of cases, and the most frequent was Streptococcus viridans. The echocardiogram showed vegetations in 80.9% of patients and 57.8% of them presented complications (the most frequent was heart failure) during hospitalization. Surgical treatment was indicated in 63.2% of cases, mainly due to heart failure. The overall hospital mortality was 30.2%. The presence of complications, requirement of surgical treatment and refractory heart failure were independent predictors of mortality whereas the single presence of vegetation showed better survival rate. The identification of these predictors could help to improve the outcomes in IE.


Assuntos
Adolescente , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Endocardite Bacteriana/mortalidade , Infecções por Bactérias Gram-Positivas/mortalidade , Argentina/epidemiologia , Endocardite Bacteriana/complicações , Endocardite Bacteriana/cirurgia , Cocos Gram-Positivos/isolamento & purificação , Hospitalização , Insuficiência Cardíaca/etiologia , Próteses Valvulares Cardíacas/efeitos adversos , Valvas Cardíacas/microbiologia , Prognóstico , Estudos Prospectivos
6.
CES med ; 25(2): 231-242, jul.-dic. 2011. graf, tab
Artigo em Espanhol | LILACS | ID: lil-616580

RESUMO

La hematuria macroscópica es un síntoma y signo clínico más que una enfermedad por sí misma, dado que detrás de ésta siempre habrá una enfermedad responsable. La hematuria macroscópica, a diferencia de la microscópica, siempre obliga al médico a estudiarla exhaustivamente puesto que múltiples enfermedades pueden ser la posible etiología y, a su vez, pudiera generarse gran morbilidad para el paciente en caso de no ser rápidamente identificadas y tratadas. La historia clínica y el examen físico del paciente son el pilar fundamental para guiar el enfoque paraclínico inicial de los pacientes. Este último debe ser iniciado con el uroanálisis y según su resultado, se deben continuar los estudios necesarios para corroborar o confirmar las sospechas diagnósticas generadas en el interrogatorio y el examen clínico inicial. Se presenta un caso inusual de una paciente de 12 años con hematuria macroscópica franca, quien llega al servicio de urgencias pediátricas sin antecedentes claros que guiaran a un diagnóstico inicial, motivo por lo cual se le realizan varios paraclínicos para descartar enfermedades frecuentemente asociadas a este motivo de consulta. Finalmente se llega a un diagnóstico inusual de cistitis hemorrágica por Enterococcus Sp., del cual no se encontraron casos reportados previamente en la literatura. Este caso inusual permite hacer una revisión de la literatura respecto a la hematuria macroscópica en la población pediátrica, con el fin de puntualizar yaclarar el enfoque diagnóstico.


Gross hematuria is more a symptom and clinical sign than a disease by itself, because behind this there is always a disease that is responsible for it. Gross hematuria always obligates to be studied because many potentially complicated diseases might generate some morbidity for patient. Clinical history and physical examination are fundamental for guiding initial laboratory approach in our patients, which should be started with an urinalysis and continued as necessary for corroborating suspected diagnosis by clinical history and physical examination. We present an unusual case of 12 years old patient with gross hematuria that comes to emergency department, some laboratories test were taken looking for the most frequent pathologies, but we made the diagnosis of a very unusual case of enterococcal hemorrhagic cystitis, about what there are no previous reports in medical literature. This unusual case allows a review of literature on macroscopic haematuria in paediatric population in order to clarify the diagnostic approach in this type of symptomatology, as was done in this patient.


Assuntos
Cistite/sangue , Bactérias Gram-Positivas , Cocos Gram-Positivos , Hemorragia
7.
Pediatr. (Asunción) ; 38(2): 123-125, ago. 2011. tab
Artigo em Espanhol | LILACS, BDNPAR | ID: lil-605218

RESUMO

Los objetivos del estudio fueron determinar la prevalencia de colonización intestinal por enterococo resistente a la vancomicina (EVR) en pacientes oncológicos con factores deriesgo y describir sus características clínicas y demográficas. Estudio longitudinal, realizado desde el 1 de diciembre del año 2008 al 30 de marzo del 2010, en =18 años de edad. 33 pacientes fueron incluidos. Se aislaron EVR en 94% (31/33), 39% (12/31)tenían entre 10 a 14 años. 58% (18/31) del sexo masculino, 21/31presentan Leucemia Linfoblástica aguda (LLA). Todos recibieron antibióticos previos, 90% (28/31) vancomicina. 84% (26/31) portaban catéteres venosos centrales (CVC), sometidosa cirugía 2/31, ARM 1/31. Se implementó precauciones de contacto. En conclusión, se observó alto porcentaje de colonización por EVR. CVC y uso de vancomicina predominaron. Es importante proseguir con la vigilancia, las medidas establecidas y el uso prudente de vancomicina.


The study objectives were to determine the prevalence of intestinal colonization by vancomycin-resistant enterococci(VRE) in cancer patients with risk factors and describe their clinical and demographic characteristics. A longitudinal study conducted between December 1, 2008 and March 30, 2010, in patients aged =18 years. A total of 33 patients were included. VRE were isolated in 94% (31/33), of whom 39% (12/31) were age 10—14 years. 58% (18/31) were male, and 21/31 presented acute lymphoblastic leukemia (ALL). All had previously received antibiotics, 90% (28/31) vancomycin. 84% (26/31) had central venous catheters (CVC), 2/31 had surgery, and 1/31 MV. Contact precautions were implemented. In conclusion, a highrate of VRE colonization was observed. CVC and use of vancomycin were predominant. It is important to continue the established measures, monitoring, and the prudent use of vancomycin.


Assuntos
Humanos , Cocos Gram-Positivos , Pediatria , Resistência a Vancomicina
8.
Biomédica (Bogotá) ; 31(1): 27-34, mar. 2011. ilus, mapas, graf, tab
Artigo em Espanhol | LILACS | ID: lil-617510

RESUMO

Introducción. La resistencia bacteriana es un problema de salud pública a nivel mundial, cuyo adecuado manejo implica el conocimiento de su presencia y comportamiento en cada uno de los países y regiones del mundo.Objetivos. Describir el perfil de resistencia a los distintos antimicrobianos marcadores en microorganismos Gram positivos identificados en hospitales colombianos.Materiales y métodos. Se realizó una revisión sistemática de la literatura indexada en Medline y Lilacs, además de la búsqueda manual de todos los números en revistas colombianas reconocidas y afines a la infectología para identificar referencias no disponibles electrónicamente.Resultados. De 34 estudios observacionales, sólo se cuenta con reportes consecutivos en años a partir del 2001, estos principalmente para Bogotá. La tasa de resistencia a la meticilina de Staphylococcus aureus y estafilococos coagulasa negativos en Bogotá, de aislamientos en servicios diferentes a la unidad de cuidados intensivos, oscilan de 35 % a 50 % y de 72 % a 76 %, respectivamente; en aislamientos de la unidad de cuidados intensivos, la resistencia osciló de 35 % a 71 % y de 74 % a 83 %, respectivamente. La tasa de resistencia a vancomicina para Enterococcus faecium en Bogotá es menor de 20 % con variaciones muy grandes con el paso de los años. Conclusiones. Hay una alta resistencia a los antibióticos marcadores en los aislamientos de Gram positivos identificados en hospitales de las principales ciudades colombianas.


Introduction. Bacterial resistance is a public health problem worldwide whose proper management requires knowledge of its presence and its behavior in each region and country. Objectives. A survey of the medical literature was conducted to identify levels of resistance to antibiotic markers in Gram positive bacterial isolates from Colombian hospitals. Materials and methods. A systematic review of the literature included articles indexed in MEDLINE and LILACS. A manual search was made of Colombian scientific journals and other infectious disease literature not available electronically. Results. A total of 34 observational studies were located, including a series of consecutive reports initiated in 2001. Most of the reports came from the city of Bogota. The rate of methicillin resistance for Staphylococcus aureus and coagulase-negative staphylococci in non intensive care unit isolates ranged between 35%-50% and 72%-76%, respectively. Resistance in intensive care unit isolates had a range between 35%-71% and 74%-83%, respectively. The rate of vancomycin-resistant Enterococcus faecium averaged less than 20% over the years but with large annual variation . Conclusions. Resistance markers appeared in high frequency among Gram positive isolates identified in hospitals in major Colombian cities.


Assuntos
Resistência Microbiana a Medicamentos , Enterococcus , Cocos Gram-Positivos , Testes de Sensibilidade Microbiana , Staphylococcus , Vigilância Sanitária
9.
Braz. j. infect. dis ; 14(1): 96-108, Jan.-Feb. 2010. tab
Artigo em Inglês | LILACS | ID: lil-545017

RESUMO

INTRODUCTION: methicillin- and also vancomycin (glycopeptide)-resistant Gram-positive organisms have emerged as an increasingly problematic cause of hospital-acquired infections, also spreading into the community. Vancomycin (glycopeptide) resistance has emerged primarily among Enterococci, but the MIC values of vancomycin for the entire Staphylococcus species are also increasing worldwide. MATERIAL AND METHODS: the aim of our review is to evaluate the efficacy and tolerability of newer antibiotics with activity against methicillin-resistant and glycopeptide-resistant Gram-positive cocci, on the ground of our experience at a tertiary care metropolitan Hospital, and the most recent literature evidences in this field. RESULTS: Quinupristin-dalfopristin, linezolid, daptomycin, and tigecycline show an excellent in vitro activity, comparable to the activity of vancomycin and teicoplanin for methicillin-resistant staphylococci, and superior to the one that vancomycin for vancomycin-resistant isolates. Dalbavancin, televancin, and oritavancin are new lipoglycopeptide agents with excellent activity against Gram-positive cocci, and have superior pharmacodynamics properties compared to vancomycin. We review the bacterial spectrum, clinical indications and practical use, pharmacologic properties, and expected adverse events and contraindications associated with each of these novel antimicrobial agents, compared with the present standard of care. DISCUSSION: linezolid activity is substantially comparable to that of vancomycin in patients with methicillin-resistant Staphylococcus aureus (MRSA) pneumonia, although its penetration into the respiratory tract is exceptionally elevated. Tigecycline has activity against both Enterococus species and MRSA; it is also active against a broad spectrum of Enterobacteriaceae and anaerobes, which allows for use intraabdominal, diabetic foot and surgical infections. Daptomycin has a rapid bactericidal activity for ...


Assuntos
Humanos , Antibacterianos/farmacologia , Infecções por Bactérias Gram-Positivas/microbiologia , Cocos Gram-Positivos/efeitos dos fármacos , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Testes de Sensibilidade Microbiana
10.
Med. U.P.B ; 28(2): 105-111, jul.-dic. 2009.
Artigo em Espanhol | LILACS | ID: lil-589359

RESUMO

Introducción: el constante incremento de la resistencia bacteriana a los antibióticos, hace necesario disponer de herramientas terapéuticas. La tigeciclina es un nuevo antibiótico, derivado de la minociclina, y ha demostrado excelente actividad in vitro en contra de un amplio espectro de microorganismos. Objetivo: describir la sensibilidad de las bacterias aerobias grampositivas y gramnegativas a la tigeciclina, aisladas de muestras clínicas, en un hospital de cuarto nivel de atención. Metodología: se realizó la identificación por medios convencionales y el estudio de sensibilidad a la tigeciclina por el método de difusión con disco, a bacterias cultivadas de muestras (con excepción de orina) provenientes de pacientes atendidos en el servicio de Urgencias y ambulatorios. Resultados: en total se estudiaron 2 515 bacterias. El 100% de las cepas de Staphylococcus aureus (651), Staphylococcus coagulasa negativa (382) y Enterococcus spp. (276) es sensible a la tigeciclina. Del mayor número de enterobacterias analizadas, Escherichia coli (511) presentó una sensibilidad del 99.8%, Klebsiella pneumoniae (332) un 93.1% y Enterobacter cloacae (129) del 96.9%. Las cepas que presentaron mecanismos de resistencia como Staphylococcus spp. oxacilino resistentes y enterobacterias productores de betalactamasas de espectro extendido presentaron altos porcentajes de sensibilidad a la tigeciclina. Conclusiones: la tigeciclina, como en la mayoría de los estudios realizados en otras regiones del mundo, presentó una excelente actividad in vitro en las bacterias cultivadas en las muestras clínicas de este Hospital y, por tanto, podría ser una opción en el tratamiento, tanto empírico como terapéutico, de las infecciones en las que esté indicado su uso.


Introduction: The steady increase in bacterial resistance to antibiotics, will require new therapeutic strategies. Tigecycline is a new antibiotic derived from minocycline, which has demonstrated excellent in vitro activity against a broad spectrum of microorganisms. Objective: To describe the sensitivity of Gram-positive and Gram-negative aerobic bacteria to tigecycline, isolated from clinical samples, in a fourth-level hospital. Methods: The identification was carried out by conventional methodsof identification and the susceptibility study to tigecycline by the disk diffusion method, to isolated bacteria specimens (except urine) from patients treated in the emergency and outpatient department. Results: A total of 2515 bacteria strains were included. 100% of strains of Staphylococcus aureus (651), Staphylococcus coagulase negative (382) and Enterococcus spp. (276), were susceptible to tigecycline. The largest number of Enterobacteriaceae tested, Escherichia coli (511) had a sensitivity of 99.8%, Klebsiella pneumoniae (332) a 93.1% and Enterobacter cloacae (129) of 96.9%. The strains that showed resistance mechanisms such as Staphylococcus spp. oxacillin-resistant or Enterobacteriaceae producing extended spectrum beta lactamases showedhigh rates of susceptibility to tigecycline. Conclusions: Tigecycline, as with most studies conducted in other regions of the world, presented an excellent in vitro activity in bacteria isolated in the clinical samples from this hospital and therefore could be an option in treating both as empirical therapy of infections in which its use is indicated.


Assuntos
Humanos , Enterobacteriaceae , Cocos Gram-Positivos
11.
West Indian med. j ; 58(6): 571-574, Dec. 2009. tab
Artigo em Inglês | LILACS | ID: lil-672543

RESUMO

OBJECTIVE: The purpose of this study is to review bacterial isolates from cases of urinary tract infection (UTI) and their antimicrobial susceptibility pattern for the years 2005-2007 in St Kitts. It is hoped that the study will be of use in the treatment of cases of UTI in St Kitts. METHODS: The laboratory records at St Francis Hospital, Basseterre, St Kitts, for bacterial isolates from cases of urinary tract infection and their susceptibility profiles for three years, 2005-2007, were retrospectively reviewed and compared. RESULTS: A total of 595 isolates of 13 species of pathogenic bacteria were recovered from cases of UTI. Escherichia coli was the predominant species recovered each year. Among the other species frequently recovered were Citrobacter spp, Enterobacter spp, Klebsiella pneumoniae and Pseudomonas aeruginosa. CONCLUSION: This study, the first of its kind from St Kitts serves to emphasize that treatment of UTI should be instituted generally on the basis of antimicrobial susceptibility tests.


OBJETIVO: El propósito de este estudio es examinar los aislados bacterianos de casos de infección del tracto urinario (ITU) y su modelo de susceptibilidad antimicrobiana durante los años 2005-2007 en Saint Kitts. Se espera que el estudio sea de utilidad en el tratamiento de casos de ITU en Saint Kitts. MÉTODOS: Los archivos de laboratorio del Hospital Saint Francis, Basseterre, Saint Kitts, sobre los aislados bacterianos de los casos de infección del tracto urinario y sus perfiles de susceptibilidad durante tres años, 2005-2007, fueron examinados y comparados retrospectivamente. RESULTADOS: Un total de 595 aislados de 13 especies de bacterias patógenas fueron recuperadas de casos de ITU. Escherichia coli fue la especie predominante recuperada cada año. Entre las otras especies frecuentemente recuperadas se hallan: Citrobacter spp, Enterobacter spp, Klebsiella pneumoniae y Pseudomonas aeruginosa. CONCLUSIÓN: Este estudio - el primero de su tipo en Saint Kitts - sirve para enfatizar que el tratamiento de la ITU generalmente debe establecerse sobre la base de pruebas de susceptibilidad antimicrobiana.


Assuntos
Humanos , Farmacorresistência Bacteriana Múltipla , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia , Enterobacteriaceae/isolamento & purificação , Cocos Gram-Positivos/isolamento & purificação , Testes de Sensibilidade Microbiana/estatística & dados numéricos , São Cristóvão e Névis/epidemiologia
12.
Braz. dent. j ; 20(4): 290-296, 2009. tab, ilus
Artigo em Inglês | LILACS | ID: lil-536317

RESUMO

This study evaluated in vitro the antibacterial activity of 4 root canal filling materials for primary teeth - zinc oxide and eugenol cement (ZOE), Calen paste thickened with zinc oxide (Calen/ZO), Sealapex sealer and EndoREZ sealer - against 5 bacterial strains commonly found in endodontic infections (Kocuria rhizophila, Enterococcus faecalis, Streptococcus mutans, Escherichia coli and Staphylococcus aureus) using the agar diffusion test (agar-well technique). Calen paste, 1 percent chlorhexidine digluconate (CHX) and distilled water served as controls. Seven wells per dish were made at equidistant points and immediately filled with the test and control materials. After incubation of the plates at 37oC for 24 h, the diameter of the zones of bacterial growth inhibition produced around the wells was measured (in mm) with a digital caliper under reflected light. Data were analyzed statistically by analysis of variance and Tukey's post-hoc test (?=0.05). There were statistically significant differences (p<0.0001) among the zones of bacterial growth inhibition produced by the different materials against all target microorganisms. K. rhizophila was inhibited more effectively (p<0.05) by ZOE, while Calen/ZO had its highest antibacterial activity against E. faecalis (p<0.05). S. mutans was inhibited by Calen/ZO, Sealapex and ZOE in the same intensity (p>0.05). E. coli was inhibited more effectively (p<0.05) by ZOE, followed by Calen/ZO and Sealapex. Calen/ZO and ZOE were equally effective (p>0.05) against S. aureus, while Sealapex had the lowest antibacterial efficacy (p<0.05) against this microorganism. EndoREZ presented antibacterial activity only against K. rhizophila and S. aureus. The Calen paste and Calen/ZO produced larger zones of inhibition than 1 percent CHX when the marker microorganism was E faecalis. In conclusion, the in vitro antibacterial activity of the 4 root canal filling materials for primary teeth against bacterial strains...


Este estudo avaliou in vitro a atividade antibacteriana de 4 materiais obturadores de canais radiculares de dentes decíduos - cimento de óxido de zinco e eugenol (OZE), pasta Calen espessada com óxido de zinco (Calen/OZ), cimento Sealapex e cimento EndoREZ - sobre 5 cepas bacterianas comumente encontradas em infecções endodônticas: Kocuria rhizophila, Enterococcus faecalis, Streptococcus mutans, Escherichia coli e Staphylococcus aureus, usando o teste de difusão em ágar (técnica do poço). A pasta Calen, digluconato de clorexidina a 1 por cento (CHX) e água destilada foram usados como controle. Sete poços por placa foram preparados em pontos eqüidistantes e imediatamente preenchidos com os materiais experimentais e controle. Após incubação das placas a 37oC por 24 h, o diâmetro dos halos de inibição do crescimento bacteriano formados ao redor dos poços foi medido (em mm) com um paquímetro digital sob luz refletida. Os dados obtidos foram submetidos à análise de variância e ao pós-teste de Tukey (?=0,05). Com relação à atividade antibacteriana, evidenciaram-se diferenças estatisticamente significantes (p<0,0001) entre os halos de inibição formados pelos diferentes materiais, para todos os microrganismos avaliados. A K. rhizophila foi inibida mais eficazmente pelo OZE (p<0,05), enquanto que o E. faecalis foi inibido mais eficazmente pela Calen/OZ (p<0,05). O S. mutans foi inibido pela Calen/OZ, cimento Sealapex e OZE na mesma intensidade (p>0,05). A E. coli foi inibida mais eficazmente pelo OZE, seguido pela Calen/OZ e pelo cimento Sealapex (p<0,05). O S. aureus foi inibido pela Calen/OZ e OZE na mesma intensidade (p>0,05), e menos intensamente pelo cimento Sealapex (p<0,05). O cimento EndoREZ apresentou atividade antibacteriana apenas frente a K. rhizophila e ao S. aureus. A pasta Calen e a Calen/OZ ocasionaram halos de inibição maiores que a CHX quando o microrganismo indicador foi o E. faecalis. Pode-se concluir que a atividade antibacteriana...


Assuntos
Humanos , Antibacterianos/farmacologia , Escherichia coli/efeitos dos fármacos , Cocos Gram-Positivos/efeitos dos fármacos , Testes de Sensibilidade Microbiana/métodos , Materiais Restauradores do Canal Radicular/farmacologia , Dente Decíduo/cirurgia , Antibacterianos/classificação , Hidróxido de Cálcio/farmacologia , Resinas Compostas/farmacologia , Combinação de Medicamentos , Materiais Restauradores do Canal Radicular/classificação , Salicilatos/farmacologia , Dente Decíduo , Dente Decíduo/metabolismo , Cimento de Óxido de Zinco e Eugenol/farmacologia , Óxido de Zinco/farmacologia
13.
Biomédica (Bogotá) ; 28(2): 284-294, jun. 2008. tab
Artigo em Espanhol | LILACS | ID: lil-503161

RESUMO

Introducción. Las fluoroquinolonas son antibióticos de amplio espectro comúnmente utilizados en el manejo de infecciones. Objetivo. Determinar los patrones de resistencia a fluoroquinolonas en aislamientos colombianos de Streptococcus pneumoniae, Staphylococcus aureus, estafilococos coagulasa negativa y enterococos de centros hospitalarios colombianos, recolectados entre 1994 y 2004. Materiales y métodos. Se realizó la determinación de concentraciones inhibitorias mínimas frente a ciprofloxacino, moxifloxacino y gatifloxacino a 270 aislamientos clínicos de S. pneumoniae, 348 de S. aureus, 176 de estafilococos coagulasa negativa y 123 de enterococos. Para los aislamientos de S. aureus resistentes a la meticilina se determinó la concentración inhibitoria mínima frente a levofloxacino y para aislamientos de S. pneumoniae se realizó la prueba de difusión en agar con discos de ofloxacino y levofloxacino. Resultados. Doscientos sesenta y nueve (99,6 por ciento) aislamientos de S. pneumoniae fueron susceptibles a gatifloxacino y moxifloxacino; para levofloxacino y ofloxacino la resistencia fue del 1,5 por ciento y 8,9 por ciento, respectivamente. El 15,9 por ciento de S. pneumoniae tuvo una concentración inhibitoria mínima ³ ³³ ³³4 µg/ml frente a ciprofloxacino. Las prevalencias de resistencia para ciprofloxacino, gatifloxacino y moxifloxacino en los 348 aislamientos de S. aureus fueron 55,4 por ciento, 54,9 por ciento y 52,6 por ciento, y en S. aureus resistentes a meticilina, fueron 92,3 por ciento, 91,3 por ciento y 87,5 por ciento y 91,8 por ciento para levofloxacino. En estafilococos coagulasa negativa y enterococos susceptibles a vancomicina se observaron tasas de resistencia entre 25,6 por ciento y 31,8 por ciento. Todos los aislamientos de enterococos resistente a vancomicina fueron resistentes a los compuestos evaluados. Conclusión. Los aislamientos colombianos de S. pneumoniae mantienen susceptibilidad a las fluoroquinolonas de última generación. La...


Assuntos
Enterococcus , Fluoroquinolonas , Cocos Gram-Positivos , Staphylococcus aureus , Streptococcus pneumoniae , Resistência Microbiana a Medicamentos
14.
West Indian med. j ; 57(2): 106-111, Mar. 2008. graf, tab
Artigo em Inglês | LILACS | ID: lil-672316

RESUMO

OBJECTIVE: The purpose of this study was to determine the synergistic activity of amikacin/ertapenem, fluoroquinolones (ciprofloxacin and levofloxacin)/ertapenem and amikacin/fluoroquinolones combinations against resistant nosocomial pathogens. METHODS: Time-kill studies were performed over 24 hours using an inoculum of 5 x 106 - 1 x 107 cfu/mL. Antibiotics were tested at the 1 x MIC and 4 x MIC concentrations. RESULTS: At MIC and/or 4 x MIC concentrations, the antibiotic combinations showed additive or synergistic activity against Acinetobacter strains and extended spectrum beta-lactamase producing Klebsiella pneumoniae. In Escherichia coli strains, synergy was seen when amikacin was combined with ertapenem, ciprofloxacin and levofloxacin; ertapenem in combination with fluoroquinolones demonstrated antagonism. In Pseudomonas aeruginosa strains, synergistic effect was exhibited by ertapenem plus amikacin and ertapenem plus fluoroquinolones. The antibiotic combinations showed antagonistic interaction in methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus faecalis. CONCLUSION: The antibiotic combinations showed additive or synergistic activity against many gram-negative pathogens.


OBJETIVO: El propósito del presente estudio fue determinar la actividad sinérgica de la amicacina/ ertapenema/fluoroquinolonas (ciprofloxacina y levofloxacina)/ertapenema y amicacina/y combinaciones de fluoroquinolonas frente a patógenos nosocomiales resistentes. MÉTODOS: Se realizaron estudios de letalidad-tiempo por 24 horas, usando un inóculo de 5 x 106 - 1 x 107 cfu/mL. Se probaron antibióticos en concentraciones de 1xCIM y 4xCIM. RESULTADOS: En concentraciones de CIM y/o 4 x CIM, las combinaciones de antibióticos mostraron actividad aditiva o sinergésica frente a las cepas Acinetobacter y Klebsiella pneumoniae productoras de la beta-lactamasa de espectro extendido. En las cepas de Escherichia coli, se observó sinergia cuando se combinó la amicacina con la ertapenema, la ciprofloxacina y la levofloxacina; la ertapenema en combinación con las fluoroquinolonas demostró antagonismo. En las cepas de Pseudomonas aeruginosa, se puso de manifiesto un efecto sinergésico al sumar la ertapenema con amicacina y la ertapenema con fluoroquinolonas. Las combinaciones antibióticas mostraron interacción antagonística en Staphylococcus aureus resistente a la meticilina y Enterococcus faecalis resistente a la vancomicina. CONCLUSIÓN: Las combinaciones antibióticas mostraron actividad aditiva o sinergésica frente a muchos patógenos gram-negativos.


Assuntos
Humanos , Amicacina/farmacologia , Antibacterianos/farmacologia , Ciprofloxacino/farmacologia , Bactérias Gram-Negativas/efeitos dos fármacos , Ofloxacino/farmacologia , beta-Lactamas/farmacologia , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/microbiologia , Sinergismo Farmacológico , Quimioterapia Combinada , Cocos Gram-Positivos/efeitos dos fármacos , Testes de Sensibilidade Microbiana
15.
Arch. venez. farmacol. ter ; 27(2): 92-104, 2008. tab
Artigo em Espanhol | LILACS | ID: lil-517110

RESUMO

Multiresistant Gram-positive cocci, including Staphylococcus aureus, the group of coagulase-negative staphylococci, Enterococcus faecalis and Enterococcus faecium, as well as Streptococcus pneumoniae and other streptococci, represent emerging pathogens. This issue is especially concerning in the setting of immunocompromised, hospitalized patients, in particular when surgery, invasive procedures, or prosthetic implants are carried out, patients are admitted in intensive care units, or underlying chronic disorders and immunodeficiency are of concern, and broad-spectrum antibiotics are widely used in the environment; moreover, a community spread of resistant Gram-positive cocci has been recognized during recent years. The spectrum of antimicrobials available for an effective management of these relevant infections is significantly threatened by the emerging of methicillin-resistant and more recently glycopeptide-resistant strains. The streptogramine association represented by quinupristin/dalfopristin, the oxazolidinone derivative linezolid, and the recently licensed daptomycin and tigecycline, together with a number of glycopeptides, fluoroquinolones, cephalosporins, and other experimental compounds, represent an effective response. It is due to the innovative mechanisms of action of these compounds, their maintained or enhanced activity against multiresistant pathogens, their effective pharmacokinetic/pharmacodynamic properties, their frequent possibility of synergistic activity with other compounds effective against Gram-positive pathogens, and a diffuse potential for a safe and easy administration, also to compromised patients.


Assuntos
Humanos , Agentes de Controle de Microrganismos , Cocos Gram-Positivos/classificação , Glicopeptídeos/análise , Oxazolidinonas/análise , Biologia Molecular
16.
Rev. argent. microbiol ; 39(4): 243-251, oct.-dic. 2007. ilus, graf, tab
Artigo em Espanhol | LILACS | ID: lil-634565

RESUMO

El objetivo principal de esta investigación fue determinar la diversidad bacteriana del proceso de biorremediación de agua contaminada con nafta en un biorreactor de lecho fluidificado en el Recinto Universitario de Mayagüez, de la Universidad de Puerto Rico. El aislamiento y la caracterización de las colonias bacterianas del sistema de biorremediación fueron realizados en medio R2A. Las pruebas morfológicas incluyeron la determinación de la morfología celular y de las colonias, y la reacción frente a la coloración de Gram. Las propiedades fisiológicas se determinaron usando el sistema Biolog® y sobre la base de la habilidad para desarrollar en medio mínimo con nafta como única fuente de carbono. La caracterización molecular se llevó a cabo por BOX-PCR y por análisis de secuencia del ADNr 16S mediante la técnica de ARDRA (amplified ribosomal DNA restriction analysis). De los 162 morfotipos de colonias aislados, 75% fueron bacilos gram-negativos, 19% bacilos gram-positivos, 5% cocos gram-negativos y 1% cocos gram-positivos. Según el análisis ARDRA, estos morfotipos se distribuyeron en 90 grupos genéticos, de los cuales 53% incluyeron cepas con crecimiento en nafta. Las 86 cepas que crecieron en nafta presentaron 52 patrones de amplificación, los que a través de BOX-PCR se agruparon en 50 grupos metabólicamente no relacionados. El alto nivel de diversidad microbiana observado en el reactor permitió la remoción del contaminante y, al parecer, fue importante para la operación estable y eficiente del sistema.


The main objective of this research project was to determine the bacterial diversity during the process of bioremediation of water contaminated with gasoline in a fluidized bed reactor at Mayagüez, PR. Isolation and characterization of bacterial populations from the bioremediation system was performed on R2A medium. Morphological tests included cellular and colonial shape and reaction to Gram coloration. Physiological properties were determined by using carbon utilization profiles (Biolog®) and by the ability of axenic cultures to use gasoline as the sole carbon source. Molecular characterization was performed by BOX-PCR and 16S rDNA sequence analysis (ARDRA). From a total of 162 distinctive isolates, 75% were gram-negative bacilli, 19% gram-positive bacilli, 5% gram-negative cocci and 1% gram-positive cocci. The 162 axenic cultures corresponded to 90 different genetic groups; 53% of which included strains with growth in gasoline as sole carbon source. The 86 strains capable of growing in gasoline corresponded to 52 different amplification patterns in BOX-PCR; which were not metabolically related (Biolog® system). The high degree of microbial diversity in the FBR allowed efficient and stable hydrocarbon removal throughout the operation of the system.


Assuntos
Reatores Biológicos/microbiologia , Água Doce/microbiologia , Gasolina , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Positivas/isolamento & purificação , Poluentes Químicos da Água/metabolismo , Técnicas de Tipagem Bacteriana , Biodegradação Ambiental , Carbono/metabolismo , DNA Bacteriano/análise , Bactérias Gram-Negativas/crescimento & desenvolvimento , Bactérias Gram-Negativas/metabolismo , Bactérias Gram-Positivas/crescimento & desenvolvimento , Bactérias Gram-Positivas/metabolismo , Cocos Gram-Positivos/crescimento & desenvolvimento , Cocos Gram-Positivos/isolamento & purificação , Cocos Gram-Positivos/metabolismo , Reação em Cadeia da Polimerase , Porto Rico , Ribotipagem , RNA Bacteriano/análise , Especificidade da Espécie
18.
Int. braz. j. urol ; 33(1): 42-49, Jan.-Feb. 2007. tab
Artigo em Inglês | LILACS | ID: lil-447465

RESUMO

OBJECTIVE: We assessed the antimicrobial resistance patterns of pathogens responsible for urinary tract infections (UTI) in outpatients in São Paulo, Brazil, as well as the Escherichia coli antimicrobial resistance trend. MATERIALS AND METHODS: Outpatients urine cultures were collected from January 2000 to December 2003. Statistical analysis considered positive results for one bacterial species with colony count > 100,000 CFU/mL. Stratification was done on age group and gender. Statistical tests used included chi-square and the chi-square test for trend to evaluate differences between susceptibility rates among age groups and ordering in the E. coli resistance rates per year, respectively. RESULTS: There were 37,261 positive results with Enterobacteriaceae isolated in 32,530 (87.3 percent) and Gram-positive cocci in 2,570 (6.9 percent) cultures. E. coli had the highest prevalence (71.6 percent). Susceptibility tests were performed in 31,716 cultures. E. coli had elevated resistance rates (> 30 percent) to ampicillin, trimethoprim-sulfamethoxazole, and tetracycline. Significant differences between age groups and ordering among years were observed. CONCLUSIONS: The use of trimethoprim-sulfamethoxazole is precluded in the population studied due to elevated resistance rates (> 30 percent) among most prevalent pathogens. Significant resistance rate differences among age groups and years were observed, particularly for fluoroquinolones. Fluoroquinolones should be used with caution. Nitrofurantoin should be used as empirical therapy for primary, non-complicated urinary tract infections.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Antibacterianos/farmacologia , Anti-Infecciosos Urinários/farmacologia , Enterobacteriaceae/efeitos dos fármacos , Cocos Gram-Positivos/efeitos dos fármacos , Infecções Urinárias/microbiologia , Brasil/epidemiologia , Farmacorresistência Bacteriana , Enterobacteriaceae/isolamento & purificação , Escherichia coli/efeitos dos fármacos , Escherichia coli/isolamento & purificação , Cocos Gram-Positivos/isolamento & purificação , Testes de Sensibilidade Microbiana , População Urbana , Infecções Urinárias/epidemiologia
19.
J. bras. pneumol ; 33(1): 43-50, jan.-fev. 2007. tab
Artigo em Português | LILACS | ID: lil-452350

RESUMO

OBJETIVO: Comparar a eficácia, segurança e tolerabilidade da azitromicina e da amoxicilina no tratamento de pacientes com quadro clínico de exacerbação infecciosa da doença pulmonar obstrutiva crônica. MÉTODOS: Seis centros brasileiros incluíram 109 pacientes com idades entre 33 e 82 anos. Desses pacientes, 102 foram randomizados para receber azitromicina (500 mg por dia por três dias, n = 49) ou amoxicilina (500 mg a cada oito horas por dez dias, n = 53). Os pacientes foram avaliados no início do estudo, após dez dias e depois de um mês. A avaliação clínica, de acordo com os sinais e sintomas presentes após dez dias e após um mês, consistiu na classificação dos casos nas categorias cura, melhora ou falha terapêutica. A avaliação microbiológica foi feita pela cultura de amostras de escarro consideradas adequadas após contagem de leucócitos e coloração de Gram. Avaliações secundárias de eficácia foram feitas com relação aos sintomas (tosse, dispnéia e expectoração) e à função pulmonar. RESULTADOS: Não houve diferenças entre as proporções de casos classificados como cura ou melhora entre os grupos tratados com a azitromicina ou a amoxicilina. Essas proporções foram, respectivamente, de 85 por cento vs. 78 por cento (p = 0,368) após dez dias, e de 83 por cento vs. 78 por cento (p = 0,571) após um mês. Também não foram encontradas diferenças significativas entre os dois grupos quando comparadas as variáveis secundárias de eficácia e a incidência de eventos adversos. CONCLUSÃO: A azitromicina tem eficácia e tolerabilidade semelhantes às da amoxicilina para o tratamento da exacerbação aguda da Doença pulmonar obstrutiva crônica.


OBJECTIVE: To compare the efficacy, safety, and tolerability of azithromycin and amoxicillin in the treatment of patients with infectious exacerbation of chronic obstructive pulmonary disease. METHODS: This study was conducted at six medical centers across Brazil and included 109 patients from 33 to 82 years of age. Of those, 102 were randomized to receive either azithromycin (500 mg/day for three days, n = 49) or amoxicillin (500 mg every eight hours for ten days, n = 53). The patients were evaluated at the study outset, on day ten, and at one month. Based on the clinical evaluation of the signs and symptoms present on day ten and at one month, the outcomes were classified as cure, improvement, or treatment failure. The microbiological evaluation was made through the culture of sputum samples that were considered appropriate samples only after leukocyte counts and Gram staining. Secondary efficacy evaluations were made in order to analyze symptoms (cough, dyspnea, and expectoration) and pulmonary function. RESULTS: There were no differences between the groups treated with azithromycin or amoxicillin in terms of the percentages of cases in which the outcomes were classified as cure or improvement: 85 percent vs. 78 percent (p = 0.368) on day ten; and 83 percent vs. 78 percent (p = 0.571) at one month. Similarly, there were no significant differences between the two groups in the secondary efficacy variables or the incidence of adverse effects. CONCLUSION: Azithromycin and amoxicillin present similar efficacy and tolerability in the treatment of acute exacerbation of chronic obstructive pulmonary disease.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Amoxicilina/uso terapêutico , Antibacterianos/uso terapêutico , Azitromicina/uso terapêutico , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Assistência Ambulatorial , Análise de Variância , Bactérias Gram-Negativas/isolamento & purificação , Cocos Gram-Positivos/isolamento & purificação , Doença Pulmonar Obstrutiva Crônica/microbiologia , Resultado do Tratamento
20.
Braz. oral res ; 21(2): 106-111, 2007. tab
Artigo em Inglês | LILACS | ID: lil-453188

RESUMO

This study assessed the level of contamination of six commercially available irreversible hydrocolloids (two containing chlorhexidine) and identified the contamination present in the materials. Petri dishes containing selective and enriched culture media were inoculated with alginate powder (0.06 g), in triplicate. After incubation (37°C/7 days), the colony-forming units (CFU) were counted and Gram stained. Biochemical identification of the different morphotypes was also performed. The contamination levels for the materials were: Jeltrate - 389 CFU/g; Jeltrate Plus - 516 CFU/g; Jeltrate Chromatic - 135 CFU/g; Hydrogum - 1,455 CFU/g; Kromopan - 840 CFU/g; and Greengel - 59 CFU/g. Gram staining revealed the presence of Gram-positive bacillus and Gram-positive cocci. The bacteria Staphylococcus epidermidis, Bacillus subtilis, Bacillus sp., Bacillus coagulans, Bacillus licheniformis, Bacillus cereus, Micrococcus luteus, and Nocardia sp.; the filamentous fungi Aspergillus niger, Aspergillus flavus, Rhizopus sp., Neurospora sp.; and the yeast Candida sp. were isolated. The contamination detected in the impression materials points out the need for adopting measures to improve the microbiological quality of these materials. The use of contaminated materials in the oral cavity goes against the basic principles for controlling cross-contamination and may represent a risk for debilitated or immunocompromised patients.


Este estudo avaliou o nível de contaminação de seis marcas comerciais de alginato (duas contendo clorexidina) e identificou a contaminação presente nesses materiais. Alíquotas de alginato (0,06 g) foram semeadas em meios de cultura seletivos e enriquecidos, em triplicata. Após incubação (37°C/7 dias), as unidades formadoras de colônia (UFC) foram contadas e foram realizadas as identificações morfotintorial (Gram) e bioquímica. Os níveis de contaminação dos materiais foram: Jeltrate - 389 UFC/g; Jeltrate Plus - 516 UFC/g; Jeltrate Chromatic - 135 UFC/g; Hydrogum - 1.455 UFC/g; Kromopan - 840 UFC/g; e Greengel - 59 UFC/g. A coloração de Gram revelou a presença de bacilos Gram-positivos e cocos Gram-positivos. As bactérias Staphylococcus epidermidis, Bacillus subtilis, Bacillus sp., Bacillus coagulans, Bacillus licheniformis, Bacillus cereus, Micrococcus luteus e Nocardia sp.; os fungos filamentosos Aspergillus niger, Aspergillus flavus, Rhizopus sp., Neurospora sp.; e a levedura Candida sp. foram isolados. A contaminação detectada nos materiais aponta a necessidade de adoção de medidas para melhorar seu controle de qualidade microbiológica. O uso de materiais contaminados na boca contradiz os princípios básicos de controle de infecção-cruzada e pode representar um risco para pacientes debilitados ou imunocomprometidos.


Assuntos
Coloides , Materiais para Moldagem Odontológica , Contaminação de Medicamentos , Fungos/isolamento & purificação , Bactérias Gram-Positivas/isolamento & purificação , Leveduras/isolamento & purificação , Infecção Hospitalar/prevenção & controle , Equipamentos Odontológicos/microbiologia , Cocos Gram-Positivos/isolamento & purificação , Técnicas Microbiológicas
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA