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Recurrent bloodstream infections caused by a Gram-positive bacterium affected an immunocompromised child. Tsukamurella pulmonis was the microorganism identified by secA1 gene sequencing. Antibiotic treatment in combination with removal of the subcutaneous port healed the patient.
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Actinobacteria/isolamento & purificação , Infecções por Bactérias Gram-Positivas/diagnóstico , Infecções por Bactérias Gram-Positivas/patologia , Proteínas de Membrana Transportadoras/genética , Sepse/diagnóstico , Sepse/patologia , Actinobacteria/classificação , Actinobacteria/genética , Antibacterianos/uso terapêutico , Pré-Escolar , DNA Bacteriano/química , DNA Bacteriano/genética , Remoção de Dispositivo , Feminino , Infecções por Bactérias Gram-Positivas/microbiologia , Humanos , Hospedeiro Imunocomprometido , Dados de Sequência Molecular , Infecções Oportunistas/diagnóstico , Infecções Oportunistas/microbiologia , Infecções Oportunistas/patologia , Recidiva , Sepse/microbiologia , Análise de Sequência de DNA , Resultado do TratamentoRESUMO
[This corrects the article DOI: 10.3389/fmicb.2022.918362.].
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Objectives: CARB-ES-19 is a comprehensive, multicenter, nationwide study integrating whole-genome sequencing (WGS) in the surveillance of carbapenemase-producing K. pneumoniae (CP-Kpn) and E. coli (CP-Eco) to determine their incidence, geographical distribution, phylogeny, and resistance mechanisms in Spain. Methods: In total, 71 hospitals, representing all 50 Spanish provinces, collected the first 10 isolates per hospital (February to May 2019); CPE isolates were first identified according to EUCAST (meropenem MIC > 0.12 mg/L with immunochromatography, colorimetric tests, carbapenem inactivation, or carbapenem hydrolysis with MALDI-TOF). Prevalence and incidence were calculated according to population denominators. Antibiotic susceptibility testing was performed using the microdilution method (EUCAST). All 403 isolates collected were sequenced for high-resolution single-nucleotide polymorphism (SNP) typing, core genome multilocus sequence typing (cgMLST), and resistome analysis. Results: In total, 377 (93.5%) CP-Kpn and 26 (6.5%) CP-Eco isolates were collected from 62 (87.3%) hospitals in 46 (92%) provinces. CP-Kpn was more prevalent in the blood (5.8%, 50/853) than in the urine (1.4%, 201/14,464). The cumulative incidence for both CP-Kpn and CP-Eco was 0.05 per 100 admitted patients. The main carbapenemase genes identified in CP-Kpn were bla OXA-48 (263/377), bla KPC-3 (62/377), bla VIM-1 (28/377), and bla NDM-1 (12/377). All isolates were susceptible to at least two antibiotics. Interregional dissemination of eight high-risk CP-Kpn clones was detected, mainly ST307/OXA-48 (16.4%), ST11/OXA-48 (16.4%), and ST512-ST258/KPC (13.8%). ST512/KPC and ST15/OXA-48 were the most frequent bacteremia-causative clones. The average number of acquired resistance genes was higher in CP-Kpn (7.9) than in CP-Eco (5.5). Conclusion: This study serves as a first step toward WGS integration in the surveillance of carbapenemase-producing Enterobacterales in Spain. We detected important epidemiological changes, including increased CP-Kpn and CP-Eco prevalence and incidence compared to previous studies, wide interregional dissemination, and increased dissemination of high-risk clones, such as ST307/OXA-48 and ST512/KPC-3.
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Introduction: Lung cancer is the leading cause of cancer-related mortality worldwide. Although lung cancer is predominantly observed in smokers, non-smoking patients account for 20% of cases worldwide. In this article, we present a case of lung adenocarcinoma that originated from a postoperative scar. We present a 62-year-old male patient who, while being studied for Paget's disease of bone, presented a 1.5 cm pulmonary nodule (SUV 1.6) as an imaging finding in the posterior segment of the left lung. He underwent a upper left lung segmentectomy. Results: During the routine follow-up of his underlying disease, 12 years after the original surgery, a pulmonary nodule was found. The particularity of the sample is based on the macroscopic observation of the tumor piece where the development of the neoplastic mass on the mechanical suture of the previous surgery performed 12 years ago is shown. Conclusion: We describe a rare cancer development mechanism in clinical practice, from chronic postoperative inflammation due to mechanical suturing.
Introducción: El cáncer de pulmón es la principal causa de mortalidad relacionada con el cáncer en todo el mundo. Aunque el cáncer de pulmón se observa predominantemente en fumadores, los pacientes no fumadores representan el 20% de los casos en todo el mundo. Objetivo: En este artículo, debatimos sobre un caso de adenocarcinoma de pulmón que se originó a partir de una cicatriz postoperatoria. Presentamos a un paciente masculino de 62 años que, mientras se estudiaba por diagnóstico de enfermedad ósea de Paget, presentaba un nódulo pulmonar de 1,5 cm (SUV 1.6) como un hallazgo de imagen en el segmento posterior del pulmón izquierdo. Se sometió a una segmentectomía pulmonar superior izquierda. Materiales y métodos: Artículo de tipo caso clínico. Se obtuvieron los datos de manera retrospectiva a partir de la historia clínica del paciente bajo normas del comité de ética. Resultados: Durante el seguimiento de rutina de su enfermedad subyacente, 12 años después de la cirugía original, se encontró un nódulo pulmonar. La particularidad de la muestra se basa en la observación macroscópica de la pieza tumoral donde se muestra el desarrollo de la masa neoplásica en la sutura mecánica de la cirugía previa realizada hace 12 años. Conclusión: Describimos un mecanismo de desarrollo oncológico poco frecuente en la práctica clínica, a partir de la inflamación crónica postoperatoria debido a la sutura mecánica.
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Adenocarcinoma de Pulmão , Cicatriz/patologia , Pneumopatias/cirurgia , Neoplasias Pulmonares , Adenocarcinoma de Pulmão/diagnóstico por imagem , Adenocarcinoma de Pulmão/cirurgia , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , PneumonectomiaRESUMO
Carbohydrate-lectin interactions are involved in important cellular recognition processes, including viral and bacterial infections, inflammation and tumor metastasis. Hence, structural studies of lectin-synthetic glycan complexes are essential for understanding lectin-recognition processes and for the further design of promising chemotherapeutics that interfere with sugar-lectin interactions. Plant lectins are excellent models for the study of the molecular-recognition process. Among them, peanut lectin (PNA) is highly relevant in the field of glycobiology because of its specificity for ß-galactosides, showing high affinity towards the Thomsen-Friedenreich antigen, a well known tumor-associated carbohydrate antigen. Given this specificity, PNA is one of the most frequently used molecular probes for the recognition of tumor cell-surface O-glycans. Thus, it has been extensively used in glycobiology for inhibition studies with a variety of ß-galactoside and ß-lactoside ligands. Here, crystal structures of PNA are reported in complex with six novel synthetic hydrolytically stable ß-N- and ß-S-galactosides. These complexes disclosed key molecular-binding interactions of the different sugars with PNA at the atomic level, revealing the roles of specific water molecules in protein-ligand recognition. Furthermore, binding-affinity studies by isothermal titration calorimetry showed dissociation-constant values in the micromolar range, as well as a positive multivalency effect in terms of affinity in the case of the divalent compounds. Taken together, this work provides a qualitative structural rationale for the upcoming synthesis of optimized glycoclusters designed for the study of lectin-mediated biological processes. The understanding of the recognition of ß-N- and ß-S-galactosides by PNA represents a benchmark in protein-carbohydrate interactions since they are novel synthetic ligands that do not belong to the family of O-linked glycosides.
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Galactosídeos , Modelos Moleculares , Aglutinina de Amendoim , Galactosídeos/química , Ligantes , Aglutinina de Amendoim/química , Ligação ProteicaRESUMO
Acinetobacter baumannii is one of the most important antibiotic-resistant nosocomial bacteria. We investigated changes in the clinical and molecular epidemiology of A. baumannii over a 10-year period. We compared the data from 2 prospective multicenter cohort studies in Spain, one performed in 2000 (183 patients) and one in 2010 (246 patients), which included consecutive patients infected or colonized by A. baumannii. Molecular typing was performed by repetitive extragenic palindromic polymerase chain reaction (REP-PCR), pulsed-field gel electrophoresis (PFGE), and multilocus sequence typing (MLST). The incidence density of A. baumannii colonization or infection increased significantly from 0.14 in 2000 to 0.52 in 2010 in medical services (pâ<â0.001). The number of non-nosocomial health care-associated cases increased from 1.2% to 14.2%, respectively (pâ<â0.001). Previous exposure to carbapenems increased in 2010 (16.9% in 2000 vs 27.3% in 2010, pâ=â0.03). The drugs most frequently used for definitive treatment of patients with infections were carbapenems in 2000 (45%) and colistin in 2010 (50.3%). There was molecular-typing evidence of an increase in the frequency of A. baumannii acquisition in non-intensive care unit wards in 2010 (7.6% in 2000 vs 19.2% in 2010, pâ=â0.01). By MSLT, the ST2 clonal group predominated and increased in 2010. This epidemic clonal group was more frequently resistant to imipenem and was associated with an increased risk of sepsis, although not with severe sepsis or mortality. Some significant changes were noted in the epidemiology of A. baumannii, which is increasingly affecting patients admitted to conventional wards and is also the cause of non-nosocomial health care-associated infections. Epidemic clones seem to combine antimicrobial resistance and the ability to spread, while maintaining their clinical virulence.
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Infecções por Acinetobacter , Acinetobacter baumannii , Carbapenêmicos/farmacologia , Colistina/farmacologia , Infecção Hospitalar , Infecções por Acinetobacter/diagnóstico , Infecções por Acinetobacter/tratamento farmacológico , Infecções por Acinetobacter/epidemiologia , Infecções por Acinetobacter/fisiopatologia , Acinetobacter baumannii/classificação , Acinetobacter baumannii/efeitos dos fármacos , Acinetobacter baumannii/isolamento & purificação , Acinetobacter baumannii/patogenicidade , Idoso , Antibacterianos/farmacologia , Técnicas de Tipagem Bacteriana , Estudos de Coortes , Contagem de Colônia Microbiana/métodos , Infecção Hospitalar/diagnóstico , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Infecção Hospitalar/fisiopatologia , Farmacorresistência Bacteriana , Eletroforese em Gel de Campo Pulsado/métodos , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Espanha/epidemiologiaRESUMO
En Antioquia, es necesario buscar una solución disponible, efectiva y económicamente viable para afrontar los problemas de la piel de los pacientes que, por accidentes o enfermedades, han disminuido su calidad de vida y se encuentran aislados a la espera de tratamientos que les permitan recuperar la funcionalidad de su cuerpo y les reduzcan los riesgos por la exposición de los tejidos internos. Las diferentes soluciones existentes en el mercado todavía no han llegado a superar algunos obstáculos tales como el cubrimiento de todas las extensiones, los altos costos, la funcionalidad de los tejidos restaurados, los rechazos de tipo inmune y la escasez de los sitios donantes. Este artículo presenta una revisión literaria que busca mostrar las diferentes alternativas de solución para pacientes con problemas de piel, dando énfasis en las soluciones clásicas aplicables y económicamente viables desde la ingeniería de tejidos en el sector antioqueño.
In Antioquia (Colombia), there are many patients who suffer dermal injuries caused by accident or disease. Therefore, it is necessary to pursue available, effective and affordable solutions to overcome dermal problems. Physicians and patients are both expecting corrective treatments that can reduce inner tissue exposition and allow the possibility of recovering skin functionality. Although there are many solutions for skin replacement, some obstacles remain, such as: high costs, limited availability of skin for implantation in extended areas, adequate functionality of the restored tissue and immunological rejection. Due to these issues, this article presents some of the existing alternative solutions for patients with skin injuries, considering the histology and physiology of the skin, and regarding the classical and economically attainable solutions to be used in Antioquia.