RESUMEN
Introducción: los programas de optimización del uso de antimicrobianos son fundamentales para mejorar los resultados clínicos de los pacientes. Objetivos: determinar el impacto en el consumo de amikacina y ceftriaxona, además de cambios de sensibilidad de las principales bacterias en la unidad de emergencias del hospital Carlos van Buren de Valparaíso, Chile, luego de la implementación de una guía para el tratamiento de la ITU alta. Materiales y método: estudio cuasi-experimental antes/después. Se implementó una guía de tratamiento para la ITU alta, la cual fue enviada vía WhatsApp a los médicos de la unidad. Luego se midieron las dosis diarias definidas (DDD) de amikacina y ceftriaxona y se compararon con las DDD de los mismos meses del año anterior. Además se extrajo la sensibilidad de E.coli, K. pneumonia y P.mirabilis aisladas de urocultivos. Resultados: posterior a la intervención hubo un aumento de las DDD de amikacina y una disminución de las de ceftriaxona. K.pneumoniae mantuvo su sensibilidad a amikacina y la aumentó para cefotaxima, ertapenem y meropenem. Conclusiones: la implementación de una guía de tratamiento de la ITU alta aumentó el consumo de amikacina y disminuyó el de ceftriaxona. K.pneumoniae aumentó su sensibilidad a cefotaxima, ertapenem y meropenem.
Introduction: different antimicrobial stewardship programs are fundamental to improve clinical results in patients. Objectives: to determine the impact on amikacin and ceftriaxone consumption, in addition to knowing changes in sensitivity of the main agents in the emergency unit of the Carlos van Buren Hospital in Valparaíso, Chile, after the implementation of a treatment guide for pyelonephritis. Materials and methods: quasi-experimental before/after study. A treatment guide was implemented for pyelonephritis. The guide was sent by WhatsApp to all clinicians in the emergency unit. Following the intervention, amikacin and ceftriaxone defined daily dose (DDD) were measured and compared with the DDD for the same months of the previous year. In addition, the sensitivity of E.coli, K. pneumonia and P.mirabilis isolated from urine cultures was extracted. Results: after the intervention there was a sustained increase of the DDD of amikacin and a decrease in the DDD of ceftriaxone in the months studied period. K. pneumoniae maintained its sensitivity to amikacin and increased it to cefotaxime, ertapenem, and meropenem. Conclusions: The guide's implementation for treatment of high UTI in the emergency unit of the Carlos van Buren hospital increased the consumption of amikacin and decreased that of ceftriaxone. K. pneumoniae increased its sensitivity to cefotaxime, ertapenem and meropenem.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Infecciones Urinarias , Amicacina , Servicios Médicos de Urgencia , Ceftriaxona , Chile , Técnicas de Laboratorio Clínico , Visualización de Datos , AntiinfecciososRESUMEN
The Wattius species occurring in the West Indies are revised for the first time. Wattius cucullatus (Pascoe), previously reported from Cuba, is diagnosed and restricted to Brazil. Wattius asperulus (Pascoe), currently a synonym of Wattius cucullatus, from Colombia is diagnosed and resurrected. All species found in the West Indies are endemic to the islands and form a single informal species-group. Three species are described: Wattius andersoni sp. n. from Cuba, Wattius emmabaconae sp. n. from Hispaniola (Dominican Republic), and Wattius viatorus sp. n. from Cuba and the Bahamas, and lectotypes are designated for Calymmus cucullatus Pascoe and Calymmus asperulus Pascoe. A key to the West Indian species is provided.
ResumenLas especies de Wattius que ocurren en las Indias Occidentales se revisan por primera vez. Wattius cucullatus (Pascoe), que se había registrado de Cuba, se diagnostica y se limita a Brasil. Wattius asperulus (Pascoe), actualmente sinónimo de Wattius cucullatus, se diagnostica y es restaurado, habitando en Colombia. Todas las especies que se encuentran en las Indias Occidentales son endémicas de las islas y forman un solo grupo informal de especies. Se describen tres especies: Wattius andersonisp. n. de Cuba, Wattius emmabaconaesp. n. de Hispaniola (República Dominicana) y Wattius viatorussp. n. de Cuba y las Bahamas. Se designan los lectotipos para Calymmus cucullatus Pascoe y Calymmus asperulus Pascoe. Se proporciona una clave de identificación para las especies que habitan las Indias Occidentales.
RESUMEN
BACKGROUND: Iron is essential for mammalian metabolism and its cellular concentration is controlled by regulating its acquisition and storage. Haemochromatosis is a condition involving iron overload that is characterised by increased duodenal iron absorption and a progressive accumulation of iron in vital organs. Hepcidin is the main hormone that regulates iron homoestasis and it is secreted by the liver. MATERIALS AND METHODS: We have studied how extended hepcidin administration affects the iron load status, plasma and tissue iron concentration, erythropoiesis and the expression of proteins involved on iron homeostasis in haemochromatotic (Hfe(-/-)) and wild-type mice. RESULTS: Hepcidin reverted the high plasma iron concentrations in Hfe(-/-) mice to normal values. The high concentration of hepatic iron was not altered in the liver of these Hfe(-/-) mice. Hepcidin administration did not disturb erythropoiesis in either Hfe(-/-) or wild-type mice and likewise, hepcidin did not modify the expression of any protein analysed in the liver, duodenum or spleen of Hfe(-/-) and wild-type mice. These data confirm that hepcidin administration diminishes plasma iron concentrations. CONCLUSION: Treatment with sustained doses of hepcidin diminishes plasma iron concentrations in Hfe(-/-) mice.
