RESUMEN
BACKGROUND: Little is known about multidrug-resistant Pseudomonas aeruginosa (MDRP) outbreaks in long-term care facilities (LTCFs). AIM: To describe an MDRP outbreak in an LTCF and to clarify risk factors for MDRP acquisition. METHODS: Patients who were positive for MDRP at an LTCF from January 2013 to January 2014 were analysed. A descriptive analysis, a case-control study, and a microbiological analysis were performed. FINDINGS: A total of 23 MDRP cases were identified, 16 of which were confirmed in sputum samples. Healthcare workers were observed violating hand hygiene procedures when performing oral, wound, and genital care. Nasogastric tube and oxygen mask use was associated with MDRP acquisition in the respiratory tract, which might have been confounded by poor hand hygiene. Sharing unhygienic devices, such as portable oral suction devices for oral care, and washing bottles and ointments for wound and genital care with inadequate disinfection could explain the transmission of MDRP in some cases. Isolates from 11 patients were found to be indistinguishable or closely related by pulsed-field gel electrophoresis and harbouring the blaGES-5 gene. Subsequent enhanced infection control measures were supported by nearby hospitals and a local public health centre. No additional cases were identified for a year after the last case occurred in January 2014. CONCLUSION: An outbreak of MDRP with an antimicrobial resistance gene, blaGES-5, occurred in a Japanese LTCF. It was successfully controlled by enhanced infection control measures, which neighbouring hospitals and a local public health centre supported.
Asunto(s)
Infección Hospitalaria/epidemiología , Brotes de Enfermedades , Control de Infecciones/métodos , Infecciones por Pseudomonas/epidemiología , Pseudomonas aeruginosa/enzimología , beta-Lactamasas/metabolismo , Anciano , Estudios de Casos y Controles , Infección Hospitalaria/prevención & control , Farmacorresistencia Bacteriana Múltiple , Femenino , Instituciones de Salud , Humanos , Japón/epidemiología , Cuidados a Largo Plazo , Masculino , Infecciones por Pseudomonas/prevención & control , Pseudomonas aeruginosa/aislamiento & purificación , Factores de RiesgoRESUMEN
In order to characterize the pharmaceutical utility of the root of Fukuchiyama-jio, which was produced as the hybrid of Rehmannia glutinosa LIBOSCH. var. purpurea MAKINO (Akaya-jio in Japanese) and Rehmannia glutinosa LIBOSCH. forma hueichingensis HSIAO (Kaikei-jio in Japanese) (Scrophulariaceae), we have investigated the chemical constituents of the root of Fukuchiyama-jio in detail in comparison with those of Akaya-jio and Kaikei-jio. Chemical analysis as well as quantitative one by means of gas liquid chromatography (GLC) have shown that the root of Fukuchiyama-jio contains a larger amount of iridoid glucosides as compared with Akaya-jio and Kaikei-jio. During these chemical analyses, a new ionone glucoside named oxyrehmaionoside B (7) along with melasmoside (6) were isolated as the characteristic constituents of Fukuchiyama-jio and the structure of 7 has been determined.
Asunto(s)
Glucósidos/análisis , Plantas Medicinales/química , Piranos/análisis , Cromatografía de Gases , Glucósidos/química , Glucósidos/aislamiento & purificación , Hibridación Genética , Iridoides , Conformación Molecular , Piranos/química , Piranos/aislamiento & purificaciónRESUMEN
The phylogenetic relationship of Atractylodes lancea, A. chinensis, A. koreana, A. ovata and A. japonica were analyzed by comparing the 2.6 kb sequence in a chloroplast gene trnK encoding tRNALys (UUU). The dried rhizomes of the former three species have been used as the crude drug "So-jutsu" and those of the latter two as "Byaku-jutsu" in Chinese and Japanese traditional medicine ("Kampo-medicine"). The trnK phylogenetic tree revealed that A. ovata is an outgroup of the five Atractylodes species examined and that A. japonica and A. lancea are most closely related. PCR amplification of trnK with HinfI digestion provided us with a simple method to distinguish A. ovata from other Atractylodes species at the molecular level.
Asunto(s)
Cloroplastos/metabolismo , Genes de Plantas/genética , Plantas Medicinales/clasificación , Secuencia de Bases , Datos de Secuencia Molecular , Sistemas de Lectura Abierta , Filogenia , Plantas Medicinales/genética , Plantas Medicinales/metabolismo , Reacción en Cadena de la Polimerasa , ARN de Transferencia de Lisina/metabolismoRESUMEN
Total DNA was extracted from the leaves of Atractylodes lancea DE CANDOLLE, A. ovata DE CANDOLLE and A. japonica KOIDZUMI ex KITAMURA of various origins and hybridized with digoxigenin-labeled rice ribosomal DNA after digestion with eight different restriction endonucleases. The resulting restriction fragment length polymorphism (RFLP) profiles allowed us to distinguish the three Atractylodes species when DNA was digested with Sac I. Although atractylon was detected in the rhizomes of some of the cultivated strains of A. lancea, their RFLP profiles clearly indicate that these plants are not hybrids of A. ovata or A. japonica. RFLP analysis also revealed the presence of intraspecific variation in DNA sequence of rRNA locus among A. lancea as well as A. japonica.