RESUMO
Acinetobacter calcoaceticus-baumannii complex isolates have been frequently associated with hospital and community infections, with A. baumannii being the most common. Other Acinetobacter spp. not belonging to this complex also cause infections in hospital settings, and the incidence has increased over the past few years. Some species of the Acinetobacter genus possess a great diversity of antibiotic resistance mechanisms, such as efflux pumps, porins, and resistance genes that can be acquired and disseminated by mobilizable genetic elements. By means of whole-genome sequencing, we describe in the clinical Acinetobacter haemolyticus strain AN54 different mechanisms of resistance that involve blaOXA-265, blaNDM-1, aphA6, aac(6')-Ig, and a resistance-nodulation-cell division-type efflux pump. This strain carries six plasmids, of which the plasmid pAhaeAN54e contains blaNDM-1 in a Tn125-like transposon that is truncated at the 3' end. This strain also has an insertion sequence IS91 and seven genes encoding hypothetical proteins. The pAhaeAN54e plasmid is nontypable and different from other plasmids carrying blaNDM-1 that have been reported in Mexico and other countries. The presence of these kinds of plasmids in an opportunistic pathogen such as A. haemolyticus highlights the role that these plasmids play in the dissemination of antibiotic resistance genes, especially against carbapenems, in Mexican hospitals.
Assuntos
Infecções por Acinetobacter/microbiologia , Acinetobacter/genética , Farmacorresistência Bacteriana/genética , Plasmídeos/genética , beta-Lactamases/genética , Acinetobacter/efeitos dos fármacos , Infecções por Acinetobacter/tratamento farmacológico , Animais , Antibacterianos/uso terapêutico , Carbapenêmicos/uso terapêutico , Criança , Elementos de DNA Transponíveis/genética , Farmacorresistência Bacteriana/efeitos dos fármacos , Humanos , Masculino , México , Testes de Sensibilidade Microbiana/métodos , Sequenciamento Completo do Genoma/métodosRESUMO
El tratamiento antimicrobiano en pacientes operados de apendicitis complicada, deben cubrir bacterias Gram negativas y anaerobios. Reportamos la frecuencia de bacterias aisladas en una población pediátrica operada de apencitis complicada en el Hospital para el Niño Poblano. Se trata de un estudio prospectiva, transversal, descriptivo. Se incluyeron 54 pacientes, con diagnóstico de apendicitis complicada. Se realizaron cutlivos de líquido peritoneal y de tejido apendicular para examen bacteriológico. El análisis de resultados fue de proporciones. Las bacterias aisladas más frecuentes fueron: Eschirichia coli, Enterococo y Bacteroides spp. Se concluyó que el cultivo de líquido peritoneal en casos de apendicitis complicada debe ser abandonado, el cirujano pediatra puede utilizar empíricamente antibióticos que cubran cepas aerobias y anaerobias, teniendo como otra referencia este reporte en pacientes pediátricos mexicanos
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Adolescente , Apendicite/complicações , Apendicite/diagnóstico , Apendicite/terapia , Bactérias Aeróbias/isolamento & purificação , Bactérias Anaeróbias/isolamento & purificação , Lavagem Peritoneal , Técnicas Bacteriológicas , Estudos Transversais , Epidemiologia Descritiva , Pediatria , Estudos ProspectivosRESUMO
Background. Infectious diseases caused by H. influenzae type b are considered preventable through vaccination with Hib conjugate vaccines. Some countries which follow Hib vaccination programs are close to eradication of the disease. In Mexico in particular, little epidemiological information is available. Methods. In this study, 90 clinical strains of H. influenzae were obtained from Mexican children who were treated in four pediatric hospitals in Puebla City, and were diagnosed with invasive or localized infectious diseases. The strains were identified by standard bacteriological methods. Biotyping was done by Kilian criteria and serotyping by coagglutination. Results. H. influenzae infections were found in children younger than 5 years of age, and 68.6 percent of the children were younger than 24 months. Sixty percent of the isolates belonged to serotype b, 31.1 percent were nontypeable, and 7.7 percent were considerer nontype b. Serotype b was the most frequent isolate associated with invasive infectious diseases; however, nontypeable strains were isolated more frequently froms children with otitis, sinusitis, conjunctivitis, and bronchial secretion. Non-type b serotypes were isolated from invasive and non-invasive infections in few cases. Biotypes I and IV were the most frequent isolates of H. influenzae. Conclusions. This study emphasizes the urgent need for an Hib-conjugated vaccine to achieve immunization in a pediatric population
