RESUMO
Objetivo: presentar la resolución quirúrgica de un caso clínico de recesiones gingivales tratadas con técnica de túnel y la evaluación de los resultados a los 180 días. Caso clínico: un paciente de sexo masculino, de 21 años de edad, concurrió a la consulta con recesiones de clase I de Miller, abfracciones e hipersensibilidad en las piezas 1.4 y 1.5. El procedimiento quirúrgico elegido fue la técnica de túnel. Se efectuó el seguimiento de la cicatrización y de la estabilidad de la cobertura radicular a los 180 días. Conclusión: el recubrimiento radicular de recesiones de clase I de Miller es altamente predecible, ya que permite anticipar una cobertura del 100 por ciento, siempre y cuando el enfoque quirúrgico esté acompañado del tratamiento de los factores etiológicos, así como támbién de la selección de una técnica adecuada
Assuntos
Humanos , Masculino , Adulto Jovem , Procedimentos Cirúrgicos Bucais/métodos , Raiz Dentária/lesões , Retração Gengival/cirurgia , Tecido Conjuntivo/transplante , Raspagem Dentária/métodos , Retalhos Cirúrgicos , Resultado do TratamentoRESUMO
Sixty-four colistin-resistant Klebsiella pneumoniae isolates recovered from clinical specimens from 57 patients admitted to Hospital de Clinicas Jose de San Martin during the period 2010-2012 were studied to describe the microbiological and epidemiological characteristics and factors associated with the emergence of colistin-resistance. Fifty-four colistin-susceptible K. pneumoniae isolates from the same period were also included in the study. The genetic relatedness among the isolates was studied by a PCR assay. Fifty percent of the resistant isolates were KPC-2 producers, 45.3% were ESBL producers and 4.7% only showed resistance to aminopenicilins. All KPC-producers (resistant and susceptible to colistin) were genotipically indistinguishable except for one, whereas the presence of 7 clonal types, which were different from the ones identified in the colistin-susceptible isolates, were detected among ESBL producers. The previous use of colistin was the main factor associated with the acquisition of resistance, and in the case of non-KPC producers the stay in ICU was another significant factor observed. Colistin resistance emerged in our hospital in the year 2010, reaching 3% in nosocomial isolates and maintaining this rate in successive years, due to the selection of resistant subpopulations in the epidemic clonal type in KPC-producers and due to the dispersion of colistin-resistant clonal types in non-KPC producing-isolates.
Assuntos
Proteínas de Bactérias/biossíntese , Colistina/farmacologia , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/enzimologia , beta-Lactamases/biossíntese , Proteínas de Bactérias/classificação , Farmacorresistência Bacteriana , Feminino , Humanos , Infecções por Klebsiella/epidemiologia , Masculino , beta-Lactamases/classificaçãoRESUMO
Sixty-four colistin-resistant Klebsiella pneumoniae isolates recovered from clinical specimens from 57 patients admitted to Hospital de Clinicas Jose de San Martin during the period 2010-2012 were studied to describe the microbiological and epidemiological characteristics and factors associated with the emergence of colistin-resistance. Fifty-four colistin-susceptible K. pneumoniae isolates from the same period were also included in the study. The genetic relatedness among the isolates was studied by a PCR assay. Fifty percent of the resistant isolates were KPC-2 producers, 45.3
were ESBL producers and 4.7
only showed resistance to aminopenicilins. All KPC-producers (resistant and susceptible to colistin) were genotipically indistinguishable except for one, whereas the presence of 7 clonal types, which were different from the ones identified in the colistin-susceptible isolates, were detected among ESBL producers. The previous use of colistin was the main factor associated with the acquisition of resistance, and in the case of non-KPC producers the stay in ICU was another significant factor observed. Colistin resistance emerged in our hospital in the year 2010, reaching 3
in nosocomial isolates and maintaining this rate in successive years, due to the selection of resistant subpopulations in the epidemic clonal type in KPC-producers and due to the dispersion of colistin-resistant clonal types in non-KPC producing-isolates.
Assuntos
Colistina/farmacologia , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/enzimologia , Proteínas de Bactérias/biossíntese , beta-Lactamases/biossíntese , Farmacorresistência Bacteriana , Feminino , Humanos , Infecções por Klebsiella/epidemiologia , Masculino , Proteínas de Bactérias/classificação , beta-Lactamases/classificaçãoRESUMO
Sixty-four colistin-resistant Klebsiella pneumoniae isolates recovered from clinical specimens from 57 patients admitted to Hospital de Clinicas Jose de San Martin during the period 2010-2012 were studied to describe the microbiological and epidemiological characteristics and factors associated with the emergence of colistin-resistance. Fifty-four colistin-susceptible K. pneumoniae isolates from the same period were also included in the study. The genetic relatedness among the isolates was studied by a PCR assay. Fifty percent of the resistant isolates were KPC-2 producers, 45.3
were ESBL producers and 4.7
only showed resistance to aminopenicilins. All KPC-producers (resistant and susceptible to colistin) were genotipically indistinguishable except for one, whereas the presence of 7 clonal types, which were different from the ones identified in the colistin-susceptible isolates, were detected among ESBL producers. The previous use of colistin was the main factor associated with the acquisition of resistance, and in the case of non-KPC producers the stay in ICU was another significant factor observed. Colistin resistance emerged in our hospital in the year 2010, reaching 3
in nosocomial isolates and maintaining this rate in successive years, due to the selection of resistant subpopulations in the epidemic clonal type in KPC-producers and due to the dispersion of colistin-resistant clonal types in non-KPC producing-isolates.
