Streptococcus gallolyticus subsp. pasteurianus en líquido cefalorraquídeo de un paciente pediátrico / [Streptococcus gallolyticus subsp. pasteurianus isolated from cerebrospinal fluid in a pediatric patient].

Streptococcus gallolyticus subsp. pasteurianus is known to cause bacterial meningitis in adults, and most of the few pediatric cases observed occurred in neonates. We report the case of a 9-month old boy with a history of repeated hospitalizations due to respiratory diseases, who presented meningitis and bacteremia by Streptococcus gallolyticus subsp. pasterianus. To our knowledge, this is the first reported case in Santa Fe to this date.

[Bacterial isolates from respiratory samples of pediatric patients with cystic fibrosis and their distribution by ages]. / Aislamientos bacterianos de muestras respiratorias de pacientes pediátricos con fibrosis quística y su distribución por edades.

The bacterial isolates from respiratory samples of 50 pediatric patients with cystic fibrosis, their distribution by ages and antimicrobial resistance pattern as well as the intermittence of isolations and coinfections, were investigated. Staphylococcus aureus was isolated in 72 % of patients, followed by Pseudomonas aeruginosa (58 %), Haemophilus. influenzae (56 %), and the Burkholderia cepacia complex (12 %). The frequency of resistance of P. aeruginosa isolates to ß-lactam antibiotics was low (13.8 %). Fifty percent of S. aureus isolates was methicillin-resistant, and 57.1 % of H. influenza was ampicillin resistant due to ß-lactamase production. In children under 4 years-old, S. aureus was predominant, followed by P. aeruginosa and H. influenzae. This order of predominance was observed in all the groups studied, except in that of children between 10 and 14 years-old. Stenotrophomonas maltophilia and Achromobacter xylosoxidans isolates were intermittent and accompanied by other microorganisms. Finally, we observed a great variety of bacterial species, which imposes stringent performance requirements for microbiological studies in all respiratory samples of these patients.

Aislamientos bacterianos de muestras respiratorias de pacientes pediátricos con fibrosis quística y su distribución por edades / [Bacterial isolates from respiratory samples of pediatric patients with cystic fibrosis and their distribution by ages].

The bacterial isolates from respiratory samples of 50 pediatric patients with cystic fibrosis, their distribution by ages and antimicrobial resistance pattern as well as the intermittence of isolations and coinfections, were investigated. Staphylococcus aureus was isolated in 72

of patients, followed by Pseudomonas aeruginosa (58

), and the Burkholderia cepacia complex (12

). The frequency of resistance of P. aeruginosa isolates to ß-lactam antibiotics was low (13.8

). Fifty percent of S. aureus isolates was methicillin-resistant, and 57.1

of H. influenza was ampicillin resistant due to ß-lactamase production. In children under 4 years-old, S. aureus was predominant, followed by P. aeruginosa and H. influenzae. This order of predominance was observed in all the groups studied, except in that of children between 10 and 14 years-old. Stenotrophomonas maltophilia and Achromobacter xylosoxidans isolates were intermittent and accompanied by other microorganisms. Finally, we observed a great variety of bacterial species, which imposes stringent performance requirements for microbiological studies in all respiratory samples of these patients.

[Streptococcus gallolyticus subsp. pasteurianus isolated from cerebrospinal fluid in a pediatric patient]. / Streptococcus gallolyticus subsp. pasteurianus en líquido cefalorraquídeo de un paciente pediátrico.

Streptococcus gallolyticus subsp. pasteurianus is known to cause bacterial meningitis in adults, and most of the few pediatric cases observed occurred in neonates. We report the case of a 9-month old boy with a history of repeated hospitalizations due to respiratory diseases, who presented meningitis and bacteremia by Streptococcus gallolyticus subsp. pasterianus. To our knowledge, this is the first reported case in Santa Fe to this date.

Aislamientos bacterianos de muestras respiratorias de pacientes pediátricos con fibrosis quística y su distribución por edades. / [Bacterial isolates from respiratory samples of pediatric patients with cystic fibrosis and their distribution by ages].

The bacterial isolates from respiratory samples of 50 pediatric patients with cystic fibrosis, their distribution by ages and antimicrobial resistance pattern as well as the intermittence of isolations and coinfections, were investigated. Staphylococcus aureus was isolated in 72

of patients, followed by Pseudomonas aeruginosa (58

), Haemophilus. influenzae (56

), and the Burkholderia cepacia complex (12

). The frequency of resistance of P. aeruginosa isolates to ß-lactam antibiotics was low (13.8

). Fifty percent of S. aureus isolates was methicillin-resistant, and 57.1

of H. influenza was ampicillin resistant due to ß-lactamase production. In children under 4 years-old, S. aureus was predominant, followed by P. aeruginosa and H. influenzae. This order of predominance was observed in all the groups studied, except in that of children between 10 and 14 years-old. Stenotrophomonas maltophilia and Achromobacter xylosoxidans isolates were intermittent and accompanied by other microorganisms. Finally, we observed a great variety of bacterial species, which imposes stringent performance requirements for microbiological studies in all respiratory samples of these patients.

Streptococcus gallolyticus subsp. pasteurianus en líquido cefalorraquídeo de un paciente pediátrico. / [Streptococcus gallolyticus subsp. pasteurianus isolated from cerebrospinal fluid in a pediatric patient].

Streptococcus gallolyticus subsp. pasteurianus is known to cause bacterial meningitis in adults, and most of the few pediatric cases observed occurred in neonates. We report the case of a 9-month old boy with a history of repeated hospitalizations due to respiratory diseases, who presented meningitis and bacteremia by Streptococcus gallolyticus subsp. pasterianus. To our knowledge, this is the first reported case in Santa Fe to this date.

A case of familial transmission of community-acquired methicillin-resistant Staphylococcus aureus carrying the Inu(A) gene in Santa Fe city, Argentina.

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is increasingly recognized as an important pathogen causing skin and soft tissue infections as well as necrotizing pneumonia. We describe a case of familial transmission of CA-MRSA between a 6-month-old boy and his mother in Santa Fe City, Argentina. Both isolates showed an identical antimicrobial susceptibility profile, carried type IV SCCmec and harboured the pvl and the lnu(A) genes. Isolates showed indistinguishable SmaI-PFGE patterns confirming their genetic relationship. These results corroborate the intrafamilial transmission of CA-MRSA and might associate this strain with the repetitive events of furunculosis within the family.

Sobrediagnóstico de amebiasis en niños con disentería / Overdiagnosis of amebiasis in children with dysentery

Existen dos amebas, morfológicamente idénticas, cuyas diferencias determinanque una de ellas, Entamoeba histolytica, pueda ser patógena. La otra, Entamoeba dispar, es inocua.Surgió la presunción de que casos tratados como amebiasis, no lo fueran. Objetivo. Identificar E. histolytica en niños con disenterías supuestamente amebianas. Métodos. Estudio transversal y observacional realizado en Santa Fe, entre marzo de 2005 y noviembre de 2007. En niños de 2 meses a 15 años con disentería y exámenes directos con E. histolytica/dispar, se realizó ELISA para detectar la adhesina de E. histolytica (adhesina Eh) en heces.Se efectuaron coloraciones para amebas, coprocultivos y se registraron datos clínicos.Resultados. De 75 casos estudiados, 35 fueron varones y 40 mujeres, con edad (mediana) de 3 años. Todos presentaron diarreas agudas con leucocitos;73 por ciento en sangre visible microcópicamente y 27 por ciento en el estudio microscópico. Tuvieron adhesina Eh positiva, 21. En 3 de ellos se detectaron trofozoítos hematófagos.Se realizaron 15 coprocultivos, en 5 desarrolló S. flexneri de tipo S2. Otros parásitos: 6 (Blastocystis homini 5).Tuvieron adhesina Eh negativa, 54. El 19 por ciento de las coloraciones demostró E. dispar.A 44 se les realizaron coprocultivos; desarrollaron bacterias invasivas 12 casos: S. flexneri de tipo S2 (13), Shigella sp (1), C. jejuni (5), otros (3). Otros parásitos: 12 (Blastocystis hominis 9).Conclusión. En este grupo de niños con disenterías amebianas, en la mitad de los casos seidentificaron bacterias invasivas y sólo en el 28 por ciento se detectó E. histolytica en heces, con lo cual cabría esperar una prevalencia de 18-38 por ciento de casos positivos en la población [IC 95 por ciento (0,179; 0,381)].

Sobrediagnóstico de amebiasis en niños con disentería / Overdiagnosis of amebiasis in children with dysentery

Existen dos amebas, morfológicamente idénticas, cuyas diferencias determinanque una de ellas, Entamoeba histolytica, pueda ser patógena. La otra, Entamoeba dispar, es inocua.Surgió la presunción de que casos tratados como amebiasis, no lo fueran. Objetivo. Identificar E. histolytica en niños con disenterías supuestamente amebianas. Métodos. Estudio transversal y observacional realizado en Santa Fe, entre marzo de 2005 y noviembre de 2007. En niños de 2 meses a 15 años con disentería y exámenes directos con E. histolytica/dispar, se realizó ELISA para detectar la adhesina de E. histolytica (adhesina Eh) en heces.Se efectuaron coloraciones para amebas, coprocultivos y se registraron datos clínicos.Resultados. De 75 casos estudiados, 35 fueron varones y 40 mujeres, con edad (mediana) de 3 años. Todos presentaron diarreas agudas con leucocitos;73 por ciento en sangre visible microcópicamente y 27 por ciento en el estudio microscópico. Tuvieron adhesina Eh positiva, 21. En 3 de ellos se detectaron trofozoítos hematófagos.Se realizaron 15 coprocultivos, en 5 desarrolló S. flexneri de tipo S2. Otros parásitos: 6 (Blastocystis homini 5).Tuvieron adhesina Eh negativa, 54. El 19 por ciento de las coloraciones demostró E. dispar.A 44 se les realizaron coprocultivos; desarrollaron bacterias invasivas 12 casos: S. flexneri de tipo S2 (13), Shigella sp (1), C. jejuni (5), otros (3). Otros parásitos: 12 (Blastocystis hominis 9).Conclusión. En este grupo de niños con disenterías amebianas, en la mitad de los casos seidentificaron bacterias invasivas y sólo en el 28 por ciento se detectó E. histolytica en heces, con lo cual cabría esperar una prevalencia de 18-38 por ciento de casos positivos en la población [IC 95 por ciento (0,179; 0,381)].(AU)

[Overdiagnosis of amebiasis in children with dysentery]. / Sobrediagnóstico de amebiasis en niños con disentería.

INTRODUCTION: There are morphologically identical amebaes, but with differences that can distinguish them; one as pathogenic: Entamoeba histolytica, and the other: Entamoeba dispar, as inoffensive. That brought the new hypothesis that many of the cases treated as amebiasis, weren't so. OBJECTIVE: To identify E. hystolitica in patients with dysentery, supposed to be caused by amebae. METHODS: Transversal and observational study performed between March 2005 and November 2007 in the city of Santa Fe, Argentina. Stools from children aged 2 months to 15 years-old with dysentery and direct exams with E. hystolitica/ dispar, were studied with ELISA to detect the adhesin of E. histolytica (adhesin Eh). Permanent stains for amebae were done as well as stool cultures. Clinical data were charted. RESULTS: 75 children were studied; 35 were male and 40, female, with a median age of 3 years-old. All of them presented diarrhea with leucocyte, 73% macroscopic blood on stool and 27% detectable on the microscope. Elisa Eh was positive in 21; 3 cases had hematophagous trophozoites. In 15 stool cultures were found: S. flexneri S2 type in 5 cases. Other parasites: 6 (Blastocystis homini 5). In 54 adhesin Eh was negative, 19% of the coulouring detected E. dispar. From 44 stool cultures: S. flexneri S2 type was detected in 13, Shigella sp in 1, C jejuni 5, other: 3. Other parasites: 12 (Blastocystis homini 9). CONCLUSION: In this group of children with "amebic dysentery", half of them developed invasive bacteriae and only 28% had E. histolytica on stools; that means that the prevalence of positive cases in the population could be 18% to 38% [CI 95% (0.179; 0.381)].