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4.
Artigo em Inglês | MEDLINE | ID: mdl-38765535

RESUMO

Objective: The aim of this study is to evaluate the etiological profile and antimicrobial resistance in breast abscess cultures from patients from the community, treated at a public hospital located in Porto Alegre, Brazil. Methods: This is an retrospective cross-sectional study that evaluated the medical records of patients with bacterial isolates in breast abscess secretion cultures and their antibiograms, from January 2010 to August 2022. Results: Based on 129 positive cultures from women from the community diagnosed with breast abscesses and treated at Fêmina Hospital, 99 (76.7%) of the patients had positive cultures for Staphylococcus sp, 91 (92%) of which were cases of Staphylococcus aureus. Regarding the resistance profile of S. aureus, 32% of the strains were resistant to clindamycin, 26% to oxacillin and 5% to trimethoprim-sulfamethoxazole. The antimicrobials vancomycin, linezolid and tigecycline did not show resistance for S. aureus. Conclusion: Staphylococcus aureus was the most common pathogen found in the breast abscess isolates during the study period. Oxacillin remains a good option for hospitalized patients. The use of sulfamethoxazole plus trimethoprim should be considered as a good option for use at home, due to its low bacterial resistance, effectiveness and low cost.


Assuntos
Abscesso , Antibacterianos , Humanos , Feminino , Estudos Transversais , Estudos Retrospectivos , Abscesso/microbiologia , Adulto , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Pessoa de Meia-Idade , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/isolamento & purificação , Brasil , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/tratamento farmacológico , Testes de Sensibilidade Microbiana , Farmacorresistência Bacteriana , Doenças Mamárias/microbiologia , Doenças Mamárias/tratamento farmacológico , Adulto Jovem , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/tratamento farmacológico , Adolescente
5.
Rev. chil. infectol ; Rev. chil. infectol;40(4): 402-406, ago. 2023. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1521838

RESUMO

INTRODUCCIÓN: El absceso renal es infrecuente en pediatría, con clínica y laboratorio inespecíficos. Ante su sospecha, es necesario realizar imágenes para establecer diagnóstico. Objetivo: Describir las características clínico-epidemiológicas, microbiológicas, diagnósticas y terapéuticas de abscesos renales en pediatría. PACIENTES Y MÉTODOS: Estudio retrospectivo, descriptivo, de pacientes internados con absceso renal, en seguimiento por Infectología del Hospital de Niños Ricardo Gutiérrez, durante 9 años. RESULTADOS: 15 pacientes (67% varones), mediana de edad 9 años (rango [r] 0,7-17). Cuatro pacientes con comorbilidades. El síntoma más frecuente fue fiebre seguido por dolor lumbar. El recuento medio de leucocitos en sangre fue de 15.700/mm3 (r: 7.100-45.000) y la PCR de 193 mg/L (r: 1-362). Cuatro pacientes presentaron urocultivo positivo: dos Escherichia coli, uno Klebsiella pneumoniae y E. coli y otro Candida albicans y K. pneumoniae. Ningún paciente presentó bacteriemia. El diagnóstico se confirmó por ecografía. Se realizó drenaje en siete pacientes, con aislamiento de Staphylococcus aureus en dos y Pseudomonas aeruginosa en uno. El tratamiento incluyó terapia combinada en 67%. Mediana de antibioterapia intravenosa fue 16 días (r: 7-49), total de 28 (r: 14-91). Un paciente requirió terapia intensiva y dos, nefrectomía. CONCLUSIÓN: Los abscesos renales son infrecuentes, con gran morbimortalidad. Sospechar en paciente con infección del tracto urinario (ITU) de evolución tórpida que persiste febril. En nuestro estudio, la alta sensibilidad de la ecografía renal permitió su diagnóstico precoz.


BACKGROUND: Renal abscesses are infrequent in pediatrics, with nonspecific clinical and laboratory findings. When suspected, imaging is essential to establish the diagnosis. Aim: To describe the clinical-epidemiological, microbiological, diagnostic and therapeutic characteristics of renal abscesses in pediatrics. METHODS: Retrospective and descriptive study of hospitalized patients with renal abscess, followed by Infectious Diseases Department of Ricardo Gutiérrez Children's Hospital during 9 years. Statistical analysis: Epi Info 7.2.2.6. RESULTS: 15 patients (67% male), median age 9 years (range [r] 0.7-17) were included. Four patients had underlying disease. The most frequent symptom was fever, with a median duration of 10 days (r:1-36), followed by lumbar pain. The median white blood cell count was 15,700/mm3 (r: 7,100-45,000) and CRP 193mg/L (r: 1-362). Four patients presented positive urine culture: 2 Escherichia coli, 1 Klebsiella pneumoniae and E. coli and 1 Candida albicans and K. pneumoniae. No patient had bacteremia. The diagnosis of abscess was confirmed by ultrasound. Surgical drainage was performed in 7 patients, with isolation of Staphylococcus aureus in 2 and Pseudomonas aeruginosa in 1. Empirical treatment included 3rd generation cephalosporin, combined in 67% of cases. The median of intravenous antibiotic therapy was 16 days (r: 7-49) with a total of 28 days (r:14-91). One patient required transfer to intensive care unit and 2 nephrectomy. CONCLUSION: Renal abscesses are infrecuent in pediatrics, but they present significant morbidity and mortality. It should be suspected in patients with urinary tract infection (UTI)with torpid evolution that persists with fever without antibiotic response. In our study, the high sensitivity of renal ultrasound allowed early diagnosis.


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Abscesso/epidemiologia , Nefropatias/epidemiologia , Bactérias/isolamento & purificação , Infecções Urinárias , Urina/microbiologia , Drenagem , Estudos Retrospectivos , Abscesso/diagnóstico , Abscesso/microbiologia , Abscesso/terapia , Hospitais Pediátricos , Nefropatias/diagnóstico , Nefropatias/microbiologia , Nefropatias/terapia , Antibacterianos/uso terapêutico
6.
Braz J Microbiol ; 52(4): 2489-2498, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34580836

RESUMO

In 2017, an adult male South American sea lion (Otaria byronia), presenting emaciation and a cervical abscess, stranded alive in Florianópolis, southern Brazil. The animal was directed to a rehabilitation center, dying a few days later. On necropsy, the main gross findings were necrotizing lymphadenitis of the right prescapular lymph node and nodular bronchopneumonia. A novel alphaherpesvirus, tentatively named Otariid alphaherpesvirus 1, was amplified in several tissue samples. No histopathologic findings associated with viral infection were observed. Additionally, pulmonary tuberculosis by Mycobacterium pinnipedii was diagnosed by histopathological, immunohistochemical, and molecular techniques. Several bacteria were cultured from antemortem and postmortem samples, including Proteus mirabilis from the cervical abscess and cardiac blood, and Escherichia coli from the cervical abscess and pericardial effusion. Flavivirus, morbillivirus, and Apicomplexa were not detected by molecular techniques. Herein, we report a novel alphaherpesvirus in a pinniped species of the family Otariidae. Although previously described in Southern Hemisphere pinniped species, including South American sea lions, there is limited information regarding M. pinnipedii impact over this group. Further research is required to determine the associated pathogenesis of this novel herpesvirus, and prevalence of Otariid alphaherpesvirus 1 and M. pinnipedii in the reproductive colonies.


Assuntos
Alphaherpesvirinae/isolamento & purificação , Mycobacterium , Leões-Marinhos , Tuberculose Pulmonar/veterinária , Abscesso/microbiologia , Animais , Brasil , Masculino , Leões-Marinhos/microbiologia , Leões-Marinhos/virologia
10.
Rev. chil. pediatr ; 91(6): 947-952, dic. 2020. ilus
Artigo em Espanhol | LILACS | ID: biblio-1508052

RESUMO

INTRODUCCIÓN: Las infecciones osteoarticulares agudas pediátricas constituyen patologías poco frecuentes, siendo de suma importancia realizar un diagnóstico precoz y tratamiento adecuado para evitar las compli caciones agudas o a largo plazo. El absceso de Brodie (AB) es una forma de osteomielitis subaguda de baja incidencia y de difícil diagnóstico, por lo que es imprescindible la sospecha clínica. OBJETIVO: Presentar un caso de AB y describir las características etiológicas y clínicas de esta patología. CASO CLÍNICO: Paciente 14 años, evaluado por dolor de muslo derecho de un mes de evolución, afebril y sin antecedente de trauma. Al examen físico no presentaba aumento de volumen, el rango de movimiento (ROM) de cadera derecha era doloroso y la sensibilidad estaba aumentada a la palpación su perficial de banda iliotibial (BIT) derecha. Estudio radiológico sin alteraciones. Por persistir síntomas se solicitó ecografía de muslo que mostró irregularidad ósea cortical. Resonancia Magnética (RM) evidenció lesión en diáfisis de fémur derecho de probable origen tumoral o infeccioso. Parámetros inflamatorios sin alteraciones. Se realizó toma de biopsia y cultivos, aislando Staphylococcus aureus multisensible. Se procedió a aseo quirúrgico y terapia antibiótica endovenosa, evolucionando favo rablemente. CONCLUSIONES: La presentación clínica y laboratorio en AB pueden ser inespecíficas. El clínico no especialista debe tener un alto índice de sospecha de esta patología como posible diagnós tico diferencial en pacientes que persisten con dolor y presentan una alteración radiológica, incluso ante la ausencia de otros síntomas y parámetros inflamatorios normales. Es importante realizar una biopsia ósea para el diagnóstico diferencial de patologías tumorales.


INTRODUCTION: Acute osteoarticular infections in children are rare pathologies, therefore early diagnosis and prompt treatment are crucial to avoid acute and long-term complications. Brodie's abscess (BA) is an un common type of subacute osteomyelitis, difficult to diagnose, so clinical suspicion is essential. OBJECTIVE: To describe a case of Brodie's abscess and its etiological and clinical features. CLINICAL CASE: A 14-year-old patient was seen at our clinic, who reported a one-month pain in the right thigh, with no history of fever or trauma. Physical examination revealed no volume increase, painful right hip range of motion, and increased sensitivity on superficial palpation of the right iliotibial band. X-rays where normal. Because of the pain persistence, an ultrasound was requested which showed a cortical irregularity. Magnetic resonance imaging (MRI) was performed and revealed a right femoral diaphysis, due to a possible bone tumor or an infectious process. Lab tests were normal. Biopsy and cultures were collected, identifying multi-sensitive Staphylococcus aureus. He was managed with debridement and intravenous antibiotics, responding positively. CONCLUSIONS: The BA's clinical features and lab tests are unspecific, therefore the non-specialist physician should strongly suspect this pathology as a possible differential diagnosis in patients who persist with pain and present imaging alterations, even when there are no other symptoms or normal inflammatory parameters. A bone biopsy is essential for the differential diagnosis of tumor pathologies.


Assuntos
Humanos , Masculino , Adolescente , Osteomielite/diagnóstico , Infecções Estafilocócicas/diagnóstico , Abscesso/diagnóstico , Osteomielite/microbiologia , Osteomielite/terapia , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/terapia , Staphylococcus aureus/isolamento & purificação , Biópsia , Imageamento por Ressonância Magnética , Terapia Combinada , Desbridamento/métodos , Diagnóstico Diferencial , Abscesso/microbiologia , Abscesso/terapia , Antibacterianos/administração & dosagem
11.
Int. j. odontostomatol. (Print) ; 14(4): 586-589, dic. 2020. graf
Artigo em Inglês | LILACS | ID: biblio-1134543

RESUMO

ABSTRACT: Our objective was report an extremely rare case of isolated meningitis and suppurative dacrioadenitis as consequences of odontogenic sinusitis. We describe the diagnostic tools including imaging and culture, as well as surgical treatment and follow-up. Our final diagnosis was odontogenic sinusitis caused by Streptococcus Anginosus complicated by isolated meningitis and lacrimal gland abscess. Urgent surgical treatment to restore the paranasal sinuses and drainage of the lacrimal gland was performed. Culture from purulent material collected from maxillary sinus indicated the targeted therapy. Clinical assessment and imaging obtained 20 days after surgery demonstrated successful results. This case emphasizes the importance of evaluating intracranial complications of rinosinusitis, the need to search for a dental infection when a maxillary sinusitis is encountered, the key role of a thorough diagnostic workup in order to plan a comprehensive and effective surgical treatment, as well as targeted medical therapy.


RESUMEN: En este estudio se informa un caso extremadamente raro de meningitis aislada y dacrioadenitis supurativa, como consecuencia de sinusitis odontogénica. Describimos las herramientas de diagnóstico que incluyen imágenes y cultivo, como también el tratamiento quirúrgico y el seguimiento. El diagnóstico final fue de sinusitis odontogénica causada por estreptococo anginoso complicado por una meningitis aislada y el absceso de la glándula lagrimal. Se realizó un tratamiento quirúrgico de urgencia para restaurar los senos paranasales y drenar la glándula lagrimal. Se determinó el tratamiento de acuerdo a los resultados de cultivo del seno maxilar. La evaluación clínica y las imágenes obtenidas 20 días después de la cirugía demostraron resultados exitosos. Es importante la evaluación de las complicaciones intracraneales de la rinosinusitis además de la necesidad de considerar una infección dental frente a una sinusitis maxilar. Por otra parte, es clave una evaluación exhaustiva de diagnóstico para planificar un tratamiento quirúrgico completo y efectivo, así como el tratamiento médico.


Assuntos
Humanos , Masculino , Adolescente , Infecções Estreptocócicas , Sinusite Maxilar/diagnóstico por imagem , Streptococcus anginosus , Abscesso/microbiologia , Tomografia Computadorizada por Raios X/métodos , Sinusite Maxilar/cirurgia , Dacriocistite/microbiologia , Infecção Focal Dentária/complicações , Infecção Focal Dentária/terapia , Seio Maxilar/cirurgia , Seio Maxilar/diagnóstico por imagem , Meningite
12.
P R Health Sci J ; 39(3): 260-263, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-33031694

RESUMO

OBJECTIVE: Emergency department (ED) visits for the treatment of skin abscesses have increased with the emergence of community-associated methicillin-resistant Staphylococcus aureus (CAMRSA). There is limited information about the bacteriology of cutaneous abscesses evaluated in ED in Puerto Rico. The purpose of our study was to characterize the pathogens cultured from abscesses of patients in the ED consulted to the Dermatology Service of University of Puerto Rico School of Medicine. METHODS: Patients with skin abscesses consulted to the Dermatology Service by the ED of P.R. Medical Center from 2012 to 2017 were included. Data retrieved included demographic information, past medical history, prior antibiotic use, distribution of lesions, and treatment provided. Bacteriology results and antimicrobial susceptibility patterns from cultured skin lesions were recorded. RESULTS: Ninety patients diagnosed with skin abscess were evaluated. All patients underwent incision and drainage; this was the sole treatment in two patients. The most frequently administered systemic therapy was oral clindamycin in 32 patients (36%). A total of 66 patients (73%) had S. aureus isolates, most of them (85%) MRSA. Among the isolates with MRSA, 14.3% were resistant to clindamycin. All MRSA strains were susceptible to tetracycline and vancomycin. CONCLUSION: There is a high prevalence of MRSA causing abscesses in the Hispanic population evaluated in an ED in Puerto Rico. Systemic antibiotic use for the treatment of skin abscesses after incision and drainage remains high despite published guidelines arguing against their widespread use. Clindamycin resistance in our patient population appears to be more frequent than previously reported.


Assuntos
Abscesso/microbiologia , Dermatopatias Bacterianas/microbiologia , Abscesso/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Clindamicina/uso terapêutico , Dermatologia , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Porto Rico , Faculdades de Medicina , Dermatopatias Bacterianas/terapia , Staphylococcus aureus/isolamento & purificação , Tetraciclina/uso terapêutico , Vancomicina/uso terapêutico , Adulto Jovem
14.
J. coloproctol. (Rio J., Impr.) ; 40(2): 129-134, Apr.-Jun. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1134971

RESUMO

ABSTRACT In order to determine the microbiology of anal abscess as a predictor of anal fistulas in patients who attended the external consultation of the Coloproctology unit of the Dr. Antonio María Pineda University Central Hospital, a prospective, descriptive, longitudinal study was conducted from September 2018 to July 2019. In this study, the population consisted of patients with a diagnosis of anal abscess, without associated comorbidities or contraindications for surgery, who agreed to be included in the study. A non-probabilistic, intentional sample consisting of 42 patients was determined. An appointment-based study protocol was applied by outpatient for patients who met the inclusion criteria applied, to perform due medical history through anamnesis, physical examination and culture taking of suppuration from the anal abscess to subsequently establish medical and surgical behavior thereof. The results were expressed in absolute numbers and percentages, a prevalence of ischiorectal abscesses was observed, followed by deep post-anal space abscesses. Anaerobic bacteria were isolated in 100% of the sample. In all fistulized patients, E. Coli was isolated as a predominant germ.


RESUMO Um estudo prospectivo, descritivo e longitudinal foi realizado de setembro de 2018 a Julho 2019 para determinar a microbiologia do abscesso anal como preditivo de fístulas anais em pacientes que compareceram à consulta externa da unidade de Coloproctologia do Hospital Central da Universidade Dr. Antonio María Pineda. Neste estudo, a população foi composta por pacientes com diagnóstico de abscesso anal, sem comorbidades ou contraindicações associadas à cirurgia, que concordaram em participar do estudo. Uma amostra intencional não probabilística, composta por 42 pacientes foi determinada. Um protocolo de estudo com base na consulta em regime ambulatorial foi aplicado aos pacientes que atenderam os critérios de inclusão estabelecidos, para realizar a anamnese, o exame físico e a devida cultura da supuração do abscesso anal para posteriormente estabelecer o comportamento médico e cirúrgico. Os resultados foram expressos em números absolutos e porcentagens, observando-se a prevalência de abscessos isquiorretais, seguidos por abscessos profundos no espaço pós-anal. Bactérias anaeróbias foram isoladas em 100% das amostras. Em todos os pacientes com fístulas, E. Coli foi isolada como um germe predominante.


Assuntos
Humanos , Masculino , Feminino , Bactérias Anaeróbias , Fístula Retal , Abscesso/microbiologia , Canal Anal , Supuração , Abscesso/cirurgia , Abscesso/diagnóstico , Escherichia coli
17.
Curr Diabetes Rev ; 16(6): 641-648, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31654516

RESUMO

INTRODUCTION: The typical factors precipitating diabetic ketoacidosis (DKA) include infections (30%), cessation of antidiabetic medication (20%), and a new diagnosis of diabetes (25%). The etiology remains unknown in 25% of cases. Less frequent causes cited in the literature include severe thyrotoxicosis and, infrequently, pericarditis. Few publications have described the role of human T lymphotropic virus type 1 (HTLV-1) in endocrine and metabolic disorders. Based on a clinical case associated with several endocrine and metabolic disorders, we suggest a potential role for HTLV-1, an endemic virus in the Amazonian area, and review the literature concerning the role of this virus in thyroiditis, pericarditis and diabetes mellitus. CASE REPORT: A fifty-year-old Surinamese woman without any medical history was admitted for diabetic ketoacidosis. No specific anti-pancreatic autoimmunity was observed, and the C-peptide level was low, indicating atypical type-1 diabetes mellitus. DKA was associated with thyrotoxicosis in the context of thyroiditis and complicated by nonbacterial pericarditis and a Staphylococcus aureus subcutaneous abscess. The patient was infected with HTLV-1. CONCLUSION: To our knowledge, this uncommon association is described for the first time. Few studies have analyzed the implications of HTLV-1 infection in thyroiditis and diabetes mellitus. We did not find any reports describing the association of pericarditis with HTLV-1 infection. Additional studies are necessary to understand the role of HTLV-1 in endocrine and cardiac disorders.


Assuntos
Abscesso/etiologia , Infecções por Deltaretrovirus/complicações , Diabetes Mellitus Tipo 1/etiologia , Cetoacidose Diabética/etiologia , Pericardite/etiologia , Tireotoxicose/etiologia , Abscesso/imunologia , Abscesso/microbiologia , Doença Aguda , Infecções por Deltaretrovirus/virologia , Diabetes Mellitus Tipo 1/terapia , Diabetes Mellitus Tipo 1/virologia , Cetoacidose Diabética/imunologia , Cetoacidose Diabética/terapia , Cetoacidose Diabética/virologia , Feminino , Vírus Linfotrópico T Tipo 1 Humano/isolamento & purificação , Humanos , Imunocompetência , Pessoa de Meia-Idade , Pericardite/virologia , Infecções Cutâneas Estafilocócicas/etiologia , Infecções Cutâneas Estafilocócicas/imunologia , Infecções Cutâneas Estafilocócicas/microbiologia , Staphylococcus aureus/isolamento & purificação , Suriname , Síndrome de Resposta Inflamatória Sistêmica/etiologia , Síndrome de Resposta Inflamatória Sistêmica/imunologia , Síndrome de Resposta Inflamatória Sistêmica/virologia , Tireoidite/virologia , Tireotoxicose/virologia
18.
Rev Chil Pediatr ; 91(6): 947-952, 2020 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-33861833

RESUMO

INTRODUCTION: Acute osteoarticular infections in children are rare pathologies, therefore early diagnosis and prompt treatment are crucial to avoid acute and long-term complications. Brodie's abscess (BA) is an un common type of subacute osteomyelitis, difficult to diagnose, so clinical suspicion is essential. Ob jective: To describe a case of Brodie's abscess and its etiological and clinical features. CLINICAL CASE: A 14-year-old patient was seen at our clinic, who reported a one-month pain in the right thigh, with no history of fever or trauma. Physical examination revealed no volume increase, painful right hip range of motion, and increased sensitivity on superficial palpation of the right iliotibial band. X-rays where normal. Because of the pain persistence, an ultrasound was requested which showed a cortical irregularity. Magnetic resonance imaging (MRI) was performed and revealed a right femoral diaphysis, due to a possible bone tumor or an infectious process. Lab tests were normal. Biopsy and cultures were collected, identifying multi-sensitive Staphylococcus aureus. He was managed with debridement and intravenous antibiotics, responding positively. CONCLUSIONS: The BA's clinical features and lab tests are unspecific, therefore the non-specialist physician should strongly suspect this pathology as a possible differential diagnosis in patients who persist with pain and present imaging alterations, even when there are no other symptoms or normal inflammatory parameters. A bone biopsy is essential for the differential diagnosis of tumor pathologies.


Assuntos
Abscesso/diagnóstico , Osteomielite/diagnóstico , Infecções Estafilocócicas/diagnóstico , Abscesso/microbiologia , Abscesso/terapia , Adolescente , Antibacterianos/administração & dosagem , Biópsia , Terapia Combinada , Desbridamento/métodos , Diagnóstico Diferencial , Humanos , Imageamento por Ressonância Magnética , Masculino , Osteomielite/microbiologia , Osteomielite/terapia , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/terapia , Staphylococcus aureus/isolamento & purificação
19.
Toxins (Basel) ; 11(12)2019 11 29.
Artigo em Inglês | MEDLINE | ID: mdl-31795440

RESUMO

Snakebite envenomation is considered a neglected tropical disease, although it also occurs outside the tropics. In this work, we analyzed the literature on Philodryas species in Chile (Philodryaschamissonis, P.simonsii, and P.tachymenoides) from 1834 to 2019, searching for epidemiological, clinical, and molecular aspects of envenomation. Ninety-one percent of the studies found regarded taxonomy, ecology, and natural history, suggesting that snakebites and venom toxins are a neglected issue in Chile. All snakebite cases reported and toxicological studies concerned the species Philodryaschamissonis. Using 185 distributional records from the literature and museum collections for this species, we show for the first time that the reported snakebite cases correlate with human population density, occurring in the Valparaiso and Metropolitan regions in Central Chile. The reduced number of snakebite cases, which were previously considered as having a low incidence in Chile, may be a consequence of under-reported cases, probably due to the inadequate publication or scarce research on this issue. Absence of information about official pharmacological treatment, post-envenoming sequels, clinical management of particular patient groups (e.g., with non-communicable diseases, pregnant women, and the elderly) was also detected. In conclusion, despite having over 185 years of literature on Chilean snakes, knowledge on the envenomation of Philodryas genus remains scarce, seriously affecting adequate medical handling during an ophidic accident. This review highlights the need to develop deep research in this area and urgent improvements to the management of this disease in Chile.


Assuntos
Colubridae/classificação , Mordeduras de Serpentes/epidemiologia , Abscesso/etiologia , Abscesso/microbiologia , Animais , Chile/epidemiologia , Colubridae/genética , Humanos , Incidência , Mordeduras de Serpentes/diagnóstico , Mordeduras de Serpentes/tratamento farmacológico , Venenos de Serpentes/genética
20.
Biochim Biophys Acta Mol Basis Dis ; 1865(10): 2657-2670, 2019 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-31299217

RESUMO

Staphylococcus aureus is the most prominent cause of skin and soft tissue infections (SSTI) worldwide. Mortality associated with invasive SSTI is a major threat to public health considering the incidence of antibiotic resistant isolates in particular methicillin resistant S. aureus both in the hospital (HA-MRSA) and in the community (CA-MRSA). To overcome the increasing difficulties in the clinical management of SSTI due to MRSA, new prophylactic and therapeutic approaches are urgently needed and a preventive vaccine would be welcome. The rational design of an anti-S. aureus vaccine requires a deep knowledge of the role that the different bacterial virulence factors play according to the type of infection. In the present study, using a set of isogenic deficient mutants and their complemented strains we determined that the staphylococcal surface proteins SpA and Sbi play an important role in the induction of inflammatory cytokines and chemokines in the skin during SSTI. SpA and Sbi initiate signaling cascades that lead to the early recruitment of neutrophils, modulate their lifespan in the skin milieu and contribute to proper abscess formation and bacterial eradication. Moreover, the expression of SpA and Sbi appear critical for skin repair and wound healing. Thus, these results indicate that SpA and Sbi can promote immune responses in the skin that are beneficial for the host and therefore, should not be neutralized with vaccine formulations designed to prevent SSTI.


Assuntos
Abscesso/imunologia , Antígenos de Bactérias/metabolismo , Proteínas de Bactérias/metabolismo , Proteínas de Transporte/metabolismo , Pele/imunologia , Infecções dos Tecidos Moles/metabolismo , Infecções Estafilocócicas/metabolismo , Staphylococcus aureus/metabolismo , Cicatrização/fisiologia , Abscesso/metabolismo , Abscesso/microbiologia , Animais , Quimiocinas/metabolismo , Citocinas/metabolismo , Modelos Animais de Doenças , Humanos , Queratinócitos , Staphylococcus aureus Resistente à Meticilina/metabolismo , Staphylococcus aureus Resistente à Meticilina/patogenicidade , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Pele/microbiologia , Pele/patologia , Infecções dos Tecidos Moles/imunologia , Infecções dos Tecidos Moles/microbiologia , Infecções dos Tecidos Moles/patologia , Infecções Estafilocócicas/imunologia , Staphylococcus aureus/patogenicidade
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