ABSTRACT
La lepra es una enfermedad infecto-contagiosa crónica, no hereditaria, curable y controlable, causada por el Mycobacterium leprae, que afecta principalmente la piel, mucosas y nervios periféricos. En Argentina es un problema regional y nacional, por la migración que abarca a las provincias de Formosa, Chaco, Corrientes, Entre Ríos, Misiones, Santa Fe y Buenos Aires. Objetivo General: determinar el comportamiento clínico-epidemiológico de la lepra en la Provincia de Santa Fe, desde el 1º de Enero del año 2012 al 31 de Agosto del año 2016. Métodos y Materiales: la información se obtuvo de la revisión de las fichas epidemiológicas, de pacientes con diagnóstico de lepra en el período abarcado. Las variables utilizadas fueron: edad y sexo del paciente, residencia, foco epidemiológico, condiciones ambientales y económicas, clínica, tipo de lepra, grado de discapacidad general y tratamiento. Resultados: se diagnosticaron 86 casos de lepra; 59,3% correspondieron al sexo masculino y 40, 7% al sexo femenino. El promedio de edad fue de 56 años. El 86% de los casos fueron multibacilares y la lepra lepromatosa, fue la forma clínica más frecuente. El 26,7% presentó discapacidad al momento del diagnóstico, 16,3% grado 1 y 10,5% grado 2. Conclusión: la detección de nuevos casos en la Provincia de Santa Fe, fue en promedio de 18 casos anuales, excluido el año 2016, en vigencia. Rosario fue el departamento con más casos registrados. El 60% de los casos se comunicó entre los 35 y 66 años; el sexo masculino fue el más afectado. Los casos multibacilares prevalecieron sobre los paucibacilares; la forma clínica más frecuente fue la lepra lepromatosa. Se estableció discapacidad en uno de cada cuatro pacientes.
Leprosy is a chronic disease which, despite having a variable clinic, is diagnosable and treatable when receiving a multidrug therapy (MDT) as the one proposed by the World Health Organization (WHO). In Argentina, it is characterized by moderate endemicity and focus on certain geographic areas (provinces of northeastern, northwest and center of Argentina). General Objective: determine the clinical and epidemiological behavior of leprosy in the province of Santa Fe. Methods and Materials: the cases reported since 1º January 2012 to 31 August 2016, were retrospectively collected from the review of the epidemiological records of the Ministry of Health, Environment and Social Action of the Province of Santa Fe. The variables were: age and sex of the patient, residence, epidemiological focus, environmental and economic conditions, kind of leprosy, degree of disability and finally the treatment. Results: 86 cases of leprosy were diagnosed: 59,3% were male and 40,7% sex, were female. The average age was 56 years. 86% of cases were multibacillary and lepromatous leprosy was the most frequent clinical form. The 26,7% had disability at the moment of diagnosis, 16,3% 10,5% grade 1 and grade 2. Conclusion: in the Province of Santa Fe, the detection of new leprosy cases have been stable in the last years, with a minimun of 17 and a maximum of 29 cases per year. Rosario was the city with more registered cases, followed by: La capital, General Obligado y Nueve de Julio. The most affected patients were male, and 60% of cases reported between 35 and 66 years. Multibacillary cases prevailed over paucibacillary; the most frequent clinical form was lepromatous leprosy. One in four patients had disability at the moment of diagnosis.
ABSTRACT
Resistance phenotypes characterized by minimum inhibitory concentration, disk diffusion and beta-lactamase production were determined in 434 isolates from patients attending the Sexually Transmitted Disease Service at Dr. José Maria Cullen Hospital in Santa Fe, Argentina. Susceptibility tests to penicillin, tetracycline, ciprofloxacin, espectinomycin, azithromycin and ceftriaxone were performed. Pulsed-field gel electrophoresis was conducted made to on three ciprofloxacin-resistant isolates. Epidemiologically speaking, three interesting events should be highlighted: during 1997, plasmid-mediated high level tetracycline-resistant strains were observed (33.3%); from 2002 to 2004 a significant increase of plasmid-mediated penicillin-resistant strains was registered (9.7% to 34.8%); and in the year 2000 the first two quinolone-resistant strains emerged in the province. In our hospital, the first azithromycin-resistant isolate emerged in 2004. We therefore emphasize the importance of the Clinical Microbiology Laboratory in order to provide information for the empiric treatment of this infection.
Subject(s)
Anti-Bacterial Agents/pharmacology , Neisseria gonorrhoeae/drug effects , Argentina , Drug Resistance, Bacterial , Hospitals , Humans , Microbial Sensitivity Tests , Neisseria gonorrhoeae/isolation & purification , Time FactorsABSTRACT
Se determinaron los fenotipos de resistencia caracterizados por la concentración inhibitoria mínima, la difusión con discos y la producción de β-lactamasa de 434 aislamientos de Neisseria gonorrhoeae obtenidos de pacientes atendidos en el Servicio de Enfermedades de Transmisión Sexual del Hospital Dr. José María Cullen, Santa Fe, Argentina. Se realizaron pruebas de sensibilidad a los siguientes antimicrobianos: penicilina, tetraciclina, ciprofloxacina, espectinomicina, azitromicina y ceftriaxona. A tres aislamientos resistentes a ciprofloxacina se les realizó electroforesis de campo pulsado. Se destacaron tres situaciones epidemiológicas de interés: en el año 1997, alta incidencia de aislamientos con resistencia plasmídica a tetraciclina (33,3%); en el período 2002-2004, un aumento significativo de la resistencia plasmídica a penicilina (9,7% a 34,8%); y en el año 2000, la emergencia de dos de los tres primeros aislamientos con resistencia a quinolonas del país. El primer aislamiento resistente a azitromicina en nuestro hospital emerge en el 2004. Este trabajo jerarquiza el rol del Laboratorio de Microbiología Clínica en la orientación del tratamiento empírico de la gonorrea.
Resistance phenotypes characterized by minimum inhibitory concentration, disk diffusion and β-lactamase production were determined in 434 isolates from patients attending the Sexually Transmitted Disease Service at Dr. José María Cullen Hospital in Santa Fe, Argentina. Susceptibility tests to penicillin, tetracycline, ciprofloxacin, espectinomycin, azithromycin and ceftriaxone were performed. Pulsed-field gel electrophoresis was conducted made to on three ciprofloxacin-resistant isolates. Epidemiologically speaking, three interesting events should be highlighted: during 1997, plasmid-mediated high level tetracycline-resistant strains were observed (33.3%); from 2002 to 2004 a significant increase of plasmid-mediated penicillin-resistant strains was registered (9.7% to 34.8%); and in the year 2000 the first two quinolone-resistant strains emerged in the province. In our hospital, the first azithromycin-resistant isolate emerged in 2004. We therefore emphasize the importance of the Clinical Microbiology Laboratory in order to provide information for the empiric treatment of this infection.
Subject(s)
Humans , Anti-Bacterial Agents/pharmacology , Neisseria gonorrhoeae/drug effects , Argentina , Drug Resistance, Bacterial , Hospitals , Microbial Sensitivity Tests , Neisseria gonorrhoeae/isolation & purification , Time FactorsABSTRACT
Detection of methicillin-resistant Staphylococcus aureus (MRSA) isolates represents a serious problem to low and media level microbiology labs. In this work cefoxitin (FOX) and cefotaxime (CTX) screen plates (AS) (8-16 microg/ml) with and without 4% of NaCl were evaluated to detect MRSA. Sensitivity, specificity, positive and negative predictive values were determined. The AS oxacillin and the agglutination test MRSA-Screen Latex for the detection of PLP2a were used as reference methods for the evaluation of the different studied screening plates. The 100% (94 strains) PLP2a positive were detected as MRSA with FOX (8 microg/ml), and CTX (8 microg/ml with 4% NaCl) AS. The advantage of FOX AS (8 microg/ml) is that it does not need the addition of NaCl, and CTX AS (8 microg/ml with 4% NaCl) is that cefotaxime is an antimicrobial easily accessible in our country.