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1.
Medicine (Baltimore) ; 99(2): e18504, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31914021

RESUMO

We aimed to evaluate the clinical significance of bacterial coexistence and the coinfection dynamics between bacteria and respiratory viruses among young children. We retrospectively analyzed clinical data from children aged < 5 years hospitalized with a community-acquired single respiratory viral infection of influenza, adenovirus, or RSV during 2 recent consecutive influenza seasons. Remnant respiratory specimens were used for bacterial PCR targeting Moraxella catarrhalis, Haemophilus influenzae, Streptococcus pneumoniae, and Staphylococcus aureus.A total of 102 children were included; median age was 0.8 years and 44.1% had underlying comorbidities. Overall, 6.8% (7/102) of cases were classified as severe diseases requiring intensive care unit admission and/or mechanical ventilation and ranged from 8.8% for a patient with RSV and 7.6% for those with adenovirus to 0% for those with influenza viruses. The overall viral-bacterial codetection rate was 59.8% (61/102); M catarrhalis was the most frequent (33.3%), followed by H influenzae (31.4%). Influenza cases showed higher bacterial codetection rates (80.0%; 8/10) compared with those with adenoviruses (69.2%; 9/13) and RSV (55.7%; 44/79). S pneumoniae and H influenzae codetections were associated with reduced severity (aOR, 0.24; 95% CI, 0.07-0.89), and reduced risk of wheezing (aOR, 0.36; 95% CI, 0.13-0.98), respectively.We observed the interactions between respiratory viruses and bacteria and the clinical significance of viral-bacterial coexistence in upper airway on disease severity. Future study will be necessary to elucidate the active interactions between different viruses and bacteria and give clues to risk stratified strategy in the management of respiratory infections among young children.


Assuntos
Adenoviridae/isolamento & purificação , Haemophilus influenzae/isolamento & purificação , Infecções Respiratórias/microbiologia , Infecções Respiratórias/virologia , Infecções por Adenoviridae/diagnóstico , Infecções por Adenoviridae/virologia , Bactérias/genética , Pré-Escolar , Coinfecção/microbiologia , Coinfecção/virologia , Infecções Comunitárias Adquiridas/diagnóstico , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/virologia , Feminino , Hospitalização , Humanos , Lactente , Recém-Nascido , Influenza Humana/diagnóstico , Influenza Humana/virologia , Masculino , Prevalência , Sons Respiratórios/diagnóstico , Sons Respiratórios/etiologia , Infecções por Vírus Respiratório Sincicial/diagnóstico , Infecções por Vírus Respiratório Sincicial/virologia , Vírus Sinciciais Respiratórios/genética , Infecções Respiratórias/diagnóstico , Infecções Respiratórias/epidemiologia , Estudos Retrospectivos , Índice de Gravidade de Doença , Staphylococcus aureus/isolamento & purificação , Streptococcus pneumoniae/isolamento & purificação , Vírus/genética
2.
BMC Infect Dis ; 19(1): 835, 2019 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-31601192

RESUMO

BACKGROUND: Increasing number of hospitalized children with community acquired pneumonia (CAP) is co-detected with Mycoplasma pneumoniae (Mp). The clinical characteristics and impact of Mp co-detected with other bacterial and/or viral pathogens remain poorly understood. The purpose of this study was to evaluate the demographic and clinical features of CAP children with Mp mono-detection and Mp co-detection. METHODS: A total of 4148 hospitalized children with CAP were recruited from January to December 2017 at the Children's Hospital of Hebei Province, affiliated to Hebei Medical University. A variety of respiratory viruses, bacteria and Mp were detected using multiple modalities. The demographic and clinical features of CAP children with Mp mono-detection and Mp co-detection were recorded and analyzed. RESULTS: Among the 110 CAP children with Mp positive, 42 (38.18%) of them were co-detected with at least one other pathogen. Co-detection was more common among children aged ≤3 years. No significant differences were found in most clinical symptoms, complications, underlying conditions and disease severity parameters among various etiological groups, with the following exceptions. First, prolonged duration of fever, lack of appetite and runny nose were more prevalent among CAP children with Mp-virus co-detection. Second, Mp-virus (excluding HRV) co-detected patients were more likely to present with prolonged duration of fever. Third, patients co-detected with Mp-bacteria were more likely to have abnormal blood gases. Additionally, CAP children with Mp-HRV co-detection were significantly more likely to report severe runny nose compared to those with Mp mono-detection. CONCLUSION: Mp co-detection with viral and/or bacterial pathogens is common in clinical practice. However, there are no apparent differences between Mp mono-detection and Mp co-detections in terms of clinical features and disease severity.


Assuntos
Infecções Comunitárias Adquiridas/diagnóstico , Mycoplasma pneumoniae/isolamento & purificação , Pneumonia por Mycoplasma/diagnóstico , Bactérias/isolamento & purificação , Líquido da Lavagem Broncoalveolar/microbiologia , Criança , Criança Hospitalizada , Pré-Escolar , Infecções Comunitárias Adquiridas/microbiologia , DNA Bacteriano/metabolismo , Feminino , Humanos , Lactente , Masculino , Mycoplasma pneumoniae/genética , Pneumonia por Mycoplasma/microbiologia , Prevalência , Estudos Prospectivos , Vírus/isolamento & purificação
3.
Orv Hetil ; 160(41): 1623-1632, 2019 Oct.
Artigo em Húngaro | MEDLINE | ID: mdl-31587580

RESUMO

Introduction: Previous data showed bacterial infections among diabetic patients to be more serious and frequent, with higher mortality rates in comparison with non-diabetics. Recent investigations, however, are contradictory. Aim: The goal of our prospective, observational study was to compare patients hospitalized on a general medical ward due to community-acquired bacterial infections with type 2 diabetes mellitus (T2DM) to those of non-diabetics (K) by 1) infection localization, 2) spectrum of pathogens, 3) three-month mortality rates. Method: Patients were consecutively involved (T2DM: n = 205, K: n = 202). We characterized the infections, clinical parameters, mortalities of the two groups, and matched them to international data. Results: No difference regarding clinical details of the groups were found except for glycemic parameters and BMI. In the T2DM group the skin- and soft tissue- (37.1%), in the K patients respiratory infections (37.1%) were the most common, followed by urinary ones (31.2% and 31.7%, respectively). Skin- and soft tissue infection incidence among T2DM subjects were higher compared to international results (37.1% vs. 16%). Co-presence of Gram positive and Gram negative bacteria in the skin- and soft tissue infections (23/76 vs. 5/46, p = 0.0149), and polymicrobial origin in the urinary tract infections (34.0% vs. 15.1%, p = 0.0335) were found to be more frequent in T2DM than in K. No difference regarding mortality rates were detected. In T2DM the skin- and soft tissue while in the K group the respiratory infections had the most death counts. Conclusions: We found higher rates of skin- and soft tissue infections among T2DM patients hospitalized on a general medical ward compared to international data. In total we did not find difference regarding three-month mortality between the groups. Our results highlight the importance of primary prevention and shows its inadequacy concerning skin and soft tissue infections among type 2 diabetics in Hungary. Orv Hetil. 2019; 160(41): 1623-1632.


Assuntos
Infecções Bacterianas/diagnóstico , Infecções Comunitárias Adquiridas/microbiologia , Diabetes Mellitus Tipo 2/complicações , Bactérias Gram-Negativas/isolamento & purificação , Bactérias Gram-Positivas/isolamento & purificação , Infecções dos Tecidos Moles/microbiologia , Infecções Urinárias/microbiologia , Adulto , Idoso , Infecções Bacterianas/epidemiologia , Infecções Comunitárias Adquiridas/epidemiologia , Diabetes Mellitus Tipo 2/microbiologia , Feminino , Humanos , Hungria/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Infecções dos Tecidos Moles/epidemiologia , Infecções Urinárias/epidemiologia
4.
Orv Hetil ; 160(40): 1574-1583, 2019 Oct.
Artigo em Húngaro | MEDLINE | ID: mdl-31565975

RESUMO

Introduction: Despite advancements in diagnostic capabilities and the availability of effective antimicrobial agents, community-acquired infections of the central nervous system (CNS) are still associated with high mortality rates. Aim: To assess the epidemiological and clinical characteristics of community-acquired CNS infections treated in the West Pannonian region between 2010 and 2016. Method: Clinical data of 176 patients were retrospectively analysed in two age cohorts: 15 to 65 and more than 65 years of age. Results: Neuroinfections were found to be bacterial in 81, viral in 91, parasitic in 1 and mixed in 3 cases during the observation period. The most frequent bacterial pathogens isolated were Streptococcus pneumoniae (20%) and Borrelia burgdorferi (16%). The most frequent viral pathogens isolated were tick-borne encephalitis virus (37%), herpes simplex virus (10%) and enterovirus (7%). Aetiology was unknown in 40 percent of all cases. The average incidence rate was 9.8/100 000 person/year with a mortality rate of 12%. In the cohort of patients aged >65 years, significantly higher frequencies of immunocompromising factors, lower Glasgow Coma Scale values at admission and confusion were observed (p-values: 0.008, 0.017, and 0.050, respectively). Prognosis was negatively influenced by low Glasgow Coma Scale values at admission (OR = 1.6 CI95%: 1.3-1.9; p<0.001), old age (OR = 6.5 CI95%: 2.5-17.1; p<0.001) and immunodeficiency (OR = 3.1 CI95%: 1.2-8.1; p = 0.019). Conclusions: S. pneumoniae remains the most frequently observed causative bacterial pathogen associated with community-acquired CNS infections. Incidence of tick-borne encephalitis in our county is higher than the national average (2.3 versus 0.35/100 000 person/year). Orv Hetil. 2019; 160(40): 1574-1583.


Assuntos
Infecções Bacterianas do Sistema Nervoso Central/microbiologia , Infecções do Sistema Nervoso Central/epidemiologia , Viroses do Sistema Nervoso Central/virologia , Infecções Comunitárias Adquiridas , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Borrelia burgdorferi/isolamento & purificação , Infecções Bacterianas do Sistema Nervoso Central/diagnóstico , Infecções do Sistema Nervoso Central/diagnóstico , Estudos de Coortes , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/virologia , Encefalite , Encefalite Transmitida por Carrapatos/epidemiologia , Enterovirus/isolamento & purificação , Infecções por Enterovirus/epidemiologia , Feminino , Humanos , Hungria/epidemiologia , Incidência , Doença de Lyme/epidemiologia , Masculino , Pessoa de Meia-Idade , Infecções Pneumocócicas/epidemiologia , Estudos Retrospectivos , Simplexvirus/isolamento & purificação , Streptococcus pneumoniae , Adulto Jovem
5.
Expert Rev Clin Pharmacol ; 12(10): 991-1002, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31516051

RESUMO

Introduction: Aspiration pneumonia is a subclass of community-acquired pneumonia that is expected to have an increasing contribution in mortality and morbidity, particularly in the elderly population over the next coming decades. While studies have revealed significant progress in identifying risk factors for aspiration pneumonia, the clinical presentation and diagnosis remain challenging to healthcare providers. Areas covered: We conducted a broad literature review using the MeSH heading in PubMed/MEDLINE of 'aspiration pneumonia' from January 1970 to July 2019. The understanding of the microbiology of aspiration pneumonia has evolved from a possible shift in the causative organisms away from anaerobes to traditional community-acquired pneumonia organisms. The importance of this shift is not yet known, but it has questioned the pathogenic role of anaerobes, appropriate anaerobic testing and the role of these pathogens in the pulmonary microbiome in patients with pneumonia. The identification of risk factors led to strategies to prevent or minimize the risk of aspiration pneumonia with moderate success. Expert opinion: Our expert opinion is that further research is needed to determine the role of the microbiome with aspiration pneumonia and patient risk factors. There is also a great need to develop clinical tools to help providers diagnose, treat, and prevent aspiration pneumonia.


Assuntos
Infecções Comunitárias Adquiridas/prevenção & controle , Pneumonia Aspirativa/prevenção & controle , Pneumonia Bacteriana/prevenção & controle , Idoso , Bactérias Anaeróbias/isolamento & purificação , Infecções Comunitárias Adquiridas/etiologia , Infecções Comunitárias Adquiridas/microbiologia , Humanos , Pneumonia Aspirativa/etiologia , Pneumonia Aspirativa/microbiologia , Pneumonia Bacteriana/etiologia , Pneumonia Bacteriana/microbiologia , Fatores de Risco
6.
Artigo em Inglês | MEDLINE | ID: mdl-31522665

RESUMO

From 1 January to 31 December 2017, 36 institutions around Australia participated in the Australian Staphylococcus aureus Sepsis Outcome Programme (ASSOP). The aim of ASSOP 2017 was to determine the proportion of Staphylococcus aureus bacteraemia (SAB) isolates in Australia that are antimicrobial resistant, with particular emphasis on susceptibility to methicillin and to characterise the molecular epidemiology of the methicillin-resistant isolates. A total of 2,515 S. aureus bacteraemia episodes were reported, of which 77% were community-onset. Approximately one in five S. aureus (19.0%) were methicillin resistant. The 30-day all-cause mortality associated with methicillin-resistant SAB was 18.7% which was significantly higher than the 14.0% mortality associated with methicillin-susceptible SAB. With the exception of the ß-lactams and erythromycin, antimicrobial resistance in methicillin-susceptible S. aureus was rare. However in addition to the ß-lactams approximately 42% of methicillin-resistant S. aureus (MRSA) were resistant to erythromycin and ciprofloxacin and approximately 14% resistant to co-trimoxazole, tetracycline and gentamicin. When applying the EUCAST breakpoints teicoplanin resistance was detected in five S. aureus isolates. Resistance was not detected for vancomycin and linezolid. Resistance to non-beta-lactam antimicrobials was largely attributable to two healthcare-associated MRSA clones: ST22-IV [2B] (EMRSA-15) and ST239-III [3A] (Aus-2/3 EMRSA). ST22-IV [2B] (EMRSA-15) is the predominant healthcare-associated clone in Australia. Seventy-five percent of methicillin-resistant SAB were due to community-associated clones. Although polyclonal approximately 74% of community-associated clones were characterised as ST93-IV [2B] (Queensland CA-MRSA), ST5-IV [2B], ST45-VT [5C2&5] and ST1-IV [2B]. CA-MRSA, in particular the ST45-VT [5C2&5] clone has acquired multiple antimicrobial resistance determinants including ciprofloxacin, erythromycin, clindamycin, gentamicin and tetracycline. ST45-VT [5C2&5] accounted for 12.8% of CA-MRSA. As CA-MRSA is well established in the Australian community it is important antimicrobial resistance patterns in community- and healthcare-associated SAB is monitored as this information will guide therapeutic practices in treating S. aureus sepsis.


Assuntos
Anti-Infecciosos/farmacologia , Bacteriemia/epidemiologia , Farmacorresistência Bacteriana Múltipla , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/efeitos dos fármacos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália/epidemiologia , Bacteriemia/microbiologia , Criança , Pré-Escolar , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Pessoa de Meia-Idade , Epidemiologia Molecular , Infecções Estafilocócicas/microbiologia , Adulto Jovem
7.
BMC Infect Dis ; 19(1): 761, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31477059

RESUMO

BACKGROUND: Aspiration pneumonia is a serious problem among elderly patients; it is caused by many risk factors including dysphagia, poor oral hygiene, malnutrition, and sedative medications. The aim of this study was to define a convenient procedure to objectively evaluate the risk of aspiration pneumonia in the clinical setting. METHODS: This prospective study included an aspiration pneumonia (AP) group, a community-acquired pneumonia (CAP) group, and a control (Con) group (patients hospitalized for lung cancer chemotherapy). We used the Oral Health Assessment Tool (OHAT), which assesses oral hygiene, and evaluated performance status, body mass index, serum albumin levels, substance P values in plasma, and oral bacterial counts. RESULTS: The oral health as assessed by the OHAT of the aspiration pneumonia group was significantly impaired compared with that of the CAP group and the control (5.13 ± 0.18, 4.40 ± 0.26, 3.90 ± 0.22, respectively; p < 0.05). The oral bacterial count in the aspiration pneumonia group (7.20 ± 0.11) was significantly higher than that in the CAP group (6.89 ± 0.12), consistent with the OHAT scores. Oral bacterial count was significantly reduced by oral care. CONCLUSIONS: OHAT and oral bacterial counts can be a tool to assess the requirement of taking oral care and other preventive procedures in patients at high risk of aspiration pneumonia.


Assuntos
Bactérias/isolamento & purificação , Biomarcadores/sangue , Avaliação Geriátrica/métodos , Mucosa Bucal/microbiologia , Pneumonia Aspirativa/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Biomarcadores/análise , Estudos de Casos e Controles , Infecções Comunitárias Adquiridas/diagnóstico , Infecções Comunitárias Adquiridas/microbiologia , Feminino , Humanos , Masculino , Microbiota/fisiologia , Pessoa de Meia-Idade , Higiene Bucal , Projetos Piloto , Pneumonia Aspirativa/sangue , Pneumonia Aspirativa/microbiologia , Prognóstico , Estudos Prospectivos , Medição de Risco , Fatores de Risco
8.
J Korean Med Sci ; 34(34): e228, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31456383

RESUMO

The susceptibility of Escherichia coli from community onset urinary tract infection (UTI) was evaluated by dividing community onset UTI into the simple community acquired-UTI (CA-UTI) and healthcare associated UTI (HCA-UTI) groups for a period of 10 years. The susceptibility of E. coli to most antibiotics, except amikacin and imipenem, continued to decrease. In the CA-UTI group, the susceptibility to cefotaxime was 88% in 2015, but rapidly decreased to 79.3% in 2017. The susceptibility to cefepime and piperacillin-tazobactam were 88.8% and 90.5% in 2017, respectively. In the HCA-UTI group, the susceptibility to most antibiotics markedly decreased to less than 60% by 2017. The incidence of ESBL-producing E. coli increased to 23.3% in the CA-UTI group in 2017.


Assuntos
Antibacterianos/farmacologia , Infecções Comunitárias Adquiridas/microbiologia , Escherichia coli/efeitos dos fármacos , Infecções Urinárias/microbiologia , Cefepima/farmacologia , Infecções Comunitárias Adquiridas/diagnóstico , Escherichia coli/isolamento & purificação , Humanos , Testes de Sensibilidade Microbiana , Combinação Piperacilina e Tazobactam/farmacologia , República da Coreia , Centros de Atenção Terciária , Infecções Urinárias/diagnóstico
9.
Artigo em Chinês | MEDLINE | ID: mdl-31446714

RESUMO

Summary A 29-year-old negro woman was admitted with external nasal pain and swelling for 5 weeks. The incision and drainage was done and a few of pus were drained out. CT scan showed the possibility of infectious lesions with nasal soft tissue swelling and increased density. The diagnosis was external nasal cellulitis, and the causative bacteria were enterobacter cloacae.


Assuntos
Infecções Comunitárias Adquiridas/diagnóstico , Enterobacter cloacae/isolamento & purificação , Infecções por Enterobacteriaceae/diagnóstico , Nariz/microbiologia , Adulto , Celulite (Flegmão)/microbiologia , Infecções Comunitárias Adquiridas/microbiologia , Feminino , Humanos
10.
Rev Esp Quimioter ; 32 Suppl 3: 17-23, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31364337

RESUMO

Ceftobiprole is a fifth-generation cephalosporin with potent antimicrobial activity against Gram positive and Gram-negative bacteria. It has been approved in major European countries for the treatment of community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP), excluding ventilator-associated pneumonia (VAP). Ceftobiprole is currently in a phase 3 clinical program for registration in the U.S. In 2015, it was designated as an infectious disease product qualified for the treatment of lung and skin infections by the FDA. The efficacy of ceftobiprole in pneumonia has been demonstrated in two-phase III clinical trials conducted in patients with CAP and HAP. The recommended dose in the adult with pneumonia is 500 mg every 8 h infused in 2 h; in case of renal failure, the regimen of administration must be adjusted according to the patient's renal function. It is not necessary to adjust the dose according to gender, age, body weight or liver failure. In case of hyperfiltration, an extension to 4 h infusion of the 500mg TID is required.


Assuntos
Antibacterianos/uso terapêutico , Cefalosporinas/uso terapêutico , Infecção Hospitalar/tratamento farmacológico , Pneumonia Bacteriana/tratamento farmacológico , Antibacterianos/administração & dosagem , Antibacterianos/metabolismo , Cefalosporinas/administração & dosagem , Cefalosporinas/metabolismo , Ensaios Clínicos como Assunto , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/microbiologia , Estado Terminal , Infecção Hospitalar/microbiologia , Esquema de Medicação , Humanos , Pneumonia Bacteriana/microbiologia , Insuficiência Renal/metabolismo
13.
Rev Esp Quimioter ; 32(4): 375-378, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31328907

RESUMO

OBJECTIVE: Treatment of uncomplicated urinary tract infections in primary care is generally empirical without requesting urine culture and based on biased resistance data collected from selected patients, most of them having risk factors for the isolation of resistant microorganisms. In order to overcome the lack of information on the real resistance rates in uncomplicated UTI, we compared antimicrobial phenotype and genotype of Escherichia coli isolated from pregnant women with asymptomatic bacteriuria (culture always performed) with those from women with uncomplicated acute cystitis (culture rarely performed) of different age groups. METHODS: Between September 2017 and March 2018, 103 urines were randomly collected from pregnant women aged between 16 and 47 with asymptomatic bacteriuria (AB) (n=42), not hospitalized women in the same age range with uncomplicated acute cystitis (UAC) (n=31) and women older than 47 not hospitalized with UAC (n=30). Bacteria identification was performed using mass spectrometry and the antibiogram by broth microdilution. Genetic typification was carried out by pulsed-field gel electrophoresis. RESULTS: There are no significant differences between the groups of patients in the antibiotic susceptibility. Likewise, as expected, a wide genetic diversity is observed among the strains of E. coli studied without significant differences between the three groups. CONCLUSIONS: We propose a simple model that could provide better guidance for selection of empirical antimicrobial therapy for non-pregnant women with UAC than do generic hospital antibiogram data based on reliably extrapolating the susceptibility data of strains isolated from pregnant women with AB as representation of women with community-acquired UAC.


Assuntos
Antibacterianos/uso terapêutico , Infecções Assintomáticas , Infecções por Escherichia coli , Escherichia coli/efeitos dos fármacos , Complicações Infecciosas na Gravidez , Infecções Urinárias , Doença Aguda , Adolescente , Adulto , Bacteriúria/microbiologia , Estudos de Casos e Controles , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/microbiologia , Cistite/tratamento farmacológico , Cistite/microbiologia , Farmacorresistência Bacteriana , Escherichia coli/genética , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/urina , Feminino , Genótipo , Humanos , Pessoa de Meia-Idade , Fenótipo , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Infecciosas na Gravidez/microbiologia , Complicações Infecciosas na Gravidez/urina , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/microbiologia , Infecções Urinárias/urina , Adulto Jovem
14.
J Med Microbiol ; 68(9): 1367-1372, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31329093

RESUMO

Methicillin-resistant Staphylococcus lugdunensis (MRSL) is increasingly recognized in healthcare and community settings. To obtain a better understanding of the emergence of MRSL, this study characterized the structure and content of the SCCmec elements harboured by 36 MRSL isolates obtained from diverse sources in Hong Kong from 2008 to 2017. The isolates were investigated by whole-genome sequencing. SCCmec types and subtypes were assigned according to the guidelines from the International Working Group on the Classification of Staphylococcal Cassette Chromosome Elements. The sequence type (ST)-SCCmec combinations in the 36 MRSL isolates were as follows: ST3-SCCmec IV (n=2), ST3-SCCmec V (n=28), ST27-SCCmec V (n=5) and ST42-SCCmec V (n=1). The two SCCmec IV elements were highly similar to the SCCmec IV element harboured by the community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) strain, JCSC6668. The J3-mec complex-J2 regions in the SCCmec V elements were highly similar to the corresponding regions in the CA-MRSA strains PM1 (n=13) or WIS (n=21). Based on the J1 to J3 sequences, the SCCmec V elements can be categorized into nine different subtypes. Our findings highlight the diversified structures of SCCmec elements among MRSL strains and their close relationship with SCCmec elements harboured by CA-MRSA.


Assuntos
Cromossomos Bacterianos/genética , Infecções Comunitárias Adquiridas/microbiologia , Genes Bacterianos/genética , Staphylococcus aureus Resistente à Meticilina/genética , Infecções Estafilocócicas/microbiologia , Staphylococcus lugdunensis/genética , Antibacterianos/farmacologia , Infecções Comunitárias Adquiridas/epidemiologia , DNA Bacteriano/genética , Genoma Bacteriano/genética , Hong Kong/epidemiologia , Humanos , Staphylococcus aureus Resistente à Meticilina/classificação , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana , Epidemiologia Molecular , Análise de Sequência de DNA , Infecções Estafilocócicas/epidemiologia , Estudantes de Medicina
16.
Rev Esp Quimioter ; 32(4): 370-374, 2019 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-31293115

RESUMO

OBJECTIVE: Methicillin-resistant Staphylococcus aureus (MRSA) is a significant pathogen causing both healthcare-associated and community-acquired infection. Rapid and accurate detection of this pathogen is crucial for the use of appropriate antimicrobial therapy and the control of nosocomial spread. METHODS: A total of 107 S. aureus strains were assayed for methicillin resistance: Vitek2® (bioMérieux), CHROMagarTM MRSA II (BD Becton Dickinson), disk diffusion in agar for cefoxitin 30 µg and immunochromatography PBP2a SA Culture Colony Test (AlereTM). The results of conventional tests were compared with the "gold standard" PCR test for mecA gene. RESULTS: Sensitivity and specificity were: disk diffusion for cefoxitin 100% and 100% respectively, Vitek2® 100 and 100%, CHROMagarTM MRSA II 100 and 96%, and ICPBP2a detection 98,25% and 100%. CONCLUSIONS: ICPBP2a Culture Colony Test (AlereTM) is fast, efficient and economical technique for detection of penicillin binding protein 2a (PBP2a) from isolates. This assay is a useful tool for the management of hospital outbreaks.


Assuntos
Técnicas Bacteriológicas/métodos , Infecções Comunitárias Adquiridas/microbiologia , Infecção Hospitalar/microbiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana/métodos , Antibacterianos/farmacologia , Proteínas de Bactérias/análise , Proteínas de Bactérias/genética , Cefoxitina/farmacologia , Meios de Cultura , Testes de Sensibilidade a Antimicrobianos por Disco-Difusão , Humanos , Imunoensaio/métodos , Staphylococcus aureus Resistente à Meticilina/genética , Proteínas de Ligação às Penicilinas/análise , Proteínas de Ligação às Penicilinas/genética , Reação em Cadeia da Polimerase/métodos , Sensibilidade e Especificidade
17.
BMC Public Health ; 19(1): 914, 2019 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-31288765

RESUMO

BACKGROUND: The first Canadian outbreak of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) was identified in 2004 in Calgary, Alberta. Using a novel model of MRSA population-based surveillance, sociodemographic risk associations, yearly geospatial dissemination and prevalence of CA-MRSA infections over an 11 year period was identified in an urban healthcare jurisdiction of Calgary. METHODS: Positive MRSA case records, patient demographics and laboratory data were obtained from a centralized Laboratory Information System of Calgary Laboratory Services in Calgary, Alberta, Canada between 2004 and 2014. Public census data was obtained from Statistics Canada, which was used to match with laboratory data and mapped using Geographic Information Systems. RESULTS: During the study period, 52.5% of positive MRSA infections in Calgary were CA-MRSA cases. The majority were CMRSA10 (USA300) clones (94.1%; n = 4255), while the remaining case (n = 266) were CMRSA7 (USA400) clones. Period prevalence of CMRSA10 increased from 3.6 cases/100000 population in 2004, to 41.3 cases/100000 population in 2014. Geospatial analysis demonstrated wide dissemination of CMRSA10 annually in the city. Those who are English speaking (RR = 0.05, p <  0.0001), identify as visible minority Chinese (RR = 0.09, p = 0.0023) or visible minority South Asian (RR = 0.25, p = 0.015), and have a high median household income (RR = 0.27, p <  0.0001) have a significantly decreased relative risk of CMRSA10 infections. CONCLUSIONS: CMRSA10 prevalence increased between 2004 and 2007, followed by a stabilization of cases by 2014. Certain sociodemographic factors were protective from CMRSA10 infections. The model of MRSA population-surveillance and geomap outbreak events can be used to track the epidemiology of MRSA in any jurisdiction.


Assuntos
Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Vigilância da População , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/microbiologia , Adulto , Alberta/epidemiologia , Feminino , Sistemas de Informação Geográfica , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Fatores de Risco , Análise Espacial
19.
J Biol Regul Homeost Agents ; 33(3): 843-847, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31184099

RESUMO

Streptococcus pneumoniae is a Gram-positive, alpha-hemolytic, facultative anaerobic coccus. It is the most common cause of community acquired pneumonia in adults and infants, and a major cause of morbidity and mortality. It is also a frequent cause of otitis media and sinus infections. It spreads through close person-to-person contact via respiratory droplets. It presents as pneumonia, bacteremia, or meningitis.


Assuntos
Infecções Comunitárias Adquiridas/microbiologia , Otite Média/microbiologia , Pneumonia Bacteriana/microbiologia , Streptococcus pneumoniae/classificação , Hospitais Universitários , Humanos , Streptococcus pneumoniae/isolamento & purificação , Suécia
20.
Int J Infect Dis ; 85: 195-202, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31226404

RESUMO

OBJECTIVES: Invasive pneumococcal disease (IPD) usually has its onset in the community (CO-IPD), but it can commence following hospitalization (HO-IPD). This study compared HO-IPD and CO-IPD cases during the implementation of the pneumococcal conjugate vaccine (PCV) program for children in Israel. METHODS: This was a nationwide retrospective cohort study of adult (age >18 years) IPD patients covering the period from the implementation of the PCV7/13 program in 2009/2010 through 2015. HO-IPD and CO-IPD were defined as IPD with onset ≥4 and ≤2 days from admission, respectively. Patient characteristics, outcome measures, serotypes, and antimicrobial susceptibility were compared for the entire cohort, followed by a matched case-control analysis. RESULTS: The study included 114 patients with HO-IPD and 2180 with CO-IPD. After matching HO-IPD to CO-IPD patients by age, sex, and comorbidities, the mortality rate and discharge to long-term care facility rate were significantly higher for HO-IPD patients than for CO-IPD patients (44.6% vs. 26.3% and 26.5% vs. 8.2%, respectively). HO-IPD isolates were less often covered by PCV13 (39.6% vs. 49.0%) and pneumococcal polysaccharide vaccine PPSV23 (56.6% vs. 71.3%) and more often resistant to penicillin (9.3% vs. 3.6%), ceftriaxone (3.8% vs. 0.75%), and levofloxacin (9.3% vs. 0.8%). CONCLUSIONS: HO-IPD was associated with higher morbidity and mortality than CO-IPD and was more often caused by non-vaccine serotypes (primarily non-PCV13 types) and antibiotic-resistant strains.


Assuntos
Infecção Hospitalar/microbiologia , Infecções Pneumocócicas/microbiologia , Adulto , Idoso , Antibacterianos/uso terapêutico , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/microbiologia , Infecções Comunitárias Adquiridas/mortalidade , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/mortalidade , Farmacorresistência Bacteriana , Feminino , Vacina Pneumocócica Conjugada Heptavalente , Hospitalização , Hospitais , Humanos , Israel , Masculino , Pessoa de Meia-Idade , Morbidade , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/mortalidade , Infecções Pneumocócicas/prevenção & controle , Vacinas Pneumocócicas , Estudos Retrospectivos , Sorogrupo , Streptococcus pneumoniae/classificação , Streptococcus pneumoniae/efeitos dos fármacos , Streptococcus pneumoniae/isolamento & purificação
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