[Profile of antimicrobial resistance in isolates of Staphylococcus spp. obtained from bovine milk in Colombia]. / Perfil de resistencia antimicrobiana en aislamientos de Staphylococcus spp. obtenidos de leche bovina en Colombia.

Staphylococcus spp. is one of the pathogens that cause bovine mastitis and may present multiple resistance to different antimicrobial groups. The aim of this study was to phenotypically identify Staphylococcus spp. isolates obtained from bovine milk and to characterize their antimicrobial resistance profile. The 101 strains were classified by phenotypic tests, their resistance to oxacillin, cefoxitin, penicillin, ampicillin, tetracycline, kanamycin, sulfamethoxazole / trimethoprim, clindamycin and erythromycin was determined by the Kirby-Bauer technique and the presence of resistance genes by PCR. A total of 65 strains was S. aureus and 36 strains were coagulase-negative staphylococci (CoNS). We found different patterns of resistance to antibiotics evaluated in strains of S. aureus and CoNS, only the resistance to ampicillin was found associated with the species (p<0.005). In the 101 strains, the mecA gene was detected in 27%, aph(3')-IIIa in 75.2%, aac(6')/aph(2")-3 in 47.4%, ant(4')-Ia in 32.7%, tetM in 63% and tetK in 43.6%; however, no association was found with the resistance to penicillin, ampicillin, cefoxitin, kanamycin and tetracycline, respectively (p>0.05). On the other hand, the blaZ gene was found in 59.4% of the 101 strains and the ermCgene in 62.3%, which was associated with resistance to ß-lactams and macrolides, respectively (p<0.001). In this study, antimicrobial multiresistance was found in S. aureus and CoNS strains. This finding impacts on the dairy industry, representing a risk to public health.

Primary antimicrobial resistance rates and prevalence of Helicobacter pylori infection in the north of Spain. A 13-year retrospective study.

OBJECTIVE: Helicobacter pylori resistance to antimicrobial agents is on the rise and it is thus imperative to be aware of local resistance rates. The main objective of the present study was to describe the evolution of primary antimicrobial resistance in H. pylori, analysing its antibiotic susceptibility over a 13-year period in a region of northern Spain, as well as host-related factors. PATIENTS AND METHODS: Between 2004 and 2016 a total of 3426 patients who met the H. pylori eradication criteria underwent gastroscopy. The gastric biopsies were processed and those testing positive for H. pylori were identified and tested for clarithromycin, metronidazole and levofloxacin susceptibility using E-test. RESULTS: H. pylori was isolated in 1604 (47%) patients, ranging from 63% (133/212) in 2004 to 39% (137/347) in 2016. Primary resistances to clarithromycin, metronidazole and levofloxacin were on average 19% (278/1116), 40% (572/865) and 17% (137/669), respectively. Clarithromycin resistance was 24% (167/686) in females and 15% (11/753) in males (p=0.0002); metronidazole resistance was 29% (72/246) in patients over 70 years compared to 42% (499/1190) in younger patients (p=0.0396); levofloxacin resistance increased with age, being 13% (57/439) in patients ≤55 years, 19% (46/236) for those between 56 and 70, and 26% (34/130) in patients >70 years (p=0.0087). DISCUSSION: A decline in the prevalence of H. pylori infection was observed over the years, along with relatively high rates of primary resistance to clarithromycin, metronidazole and levofloxacin. Variations in resistance rates were found with sex and age.

Rapid methods for detection of bacterial resistance to antibiotics. / Métodos rápidos para la detección de la resistencia bacteriana a antibióticos.

The most widely used antibiotic susceptibility testing methods in Clinical Microbiology are based on the phenotypic detection of antibiotic resistance by measuring bacterial growth in the presence of the antibiotic being tested. These conventional methods take typically 24hours to obtain results. Here we review the main techniques for rapid determination of antibiotic susceptibility. Data obtained with different methods such as molecular techniques, microarrays, commercial methods used in work routine, immunochromatographic methods, colorimetric methods, image methods, nephelometry, MALDI-TOF mass spectrometry, flow cytometry, chemiluminescence and bioluminescence, microfluids and methods based on cell disruption are analysed in detail.

[Rapid antibiotic susceptibility test in Clinical Microbiology]. / Antibiograma rápido en Microbiología Clínica.

The most widely used antibiotic susceptibility testing methods in Clinical Microbiology are based on the phenotypic detection of antibiotic resistance by measuring bacterial growth in the presence of the antibiotic being tested. These conventional methods take typically 24hours to obtain results. A review is presented here of recently developed techniques for the rapid determination of antibiotic susceptibility. Data obtained with different methods such as molecular techniques, flow cytometry, chemiluminescence, mass spectrometry, commercial methods used in routine work, colorimetric methods, nephelometry, microarrays, microfluids, and methods based on cell disruption and sequencing, are analyzed and discussed in detail.

[Antimicrobial susceptibility cumulative reports]. / Informes acumulados de sensibilidad a los antimicrobianos.

Cumulative reports on antimicrobial susceptibility tests data are important for selecting empirical treatments, as an educational tool in programs on antimicrobial use, and for establishing breakpoints defining clinical categories. These reports should be based on data validated by clinical microbiologists using diagnostic samples (not surveillance samples). In order to avoid a bias derived from including several isolates obtained from the same patient, it is recommended that, for a defined period, only the first isolate is counted. A minimal number of isolates per species should be presented: a figure of >=30 isolates is statistically acceptable. The report is usually presented in a table format where, for each cell, information on clinically relevant microorganisms-antimicrobial agents is presented. Depending on particular needs, multiple tables showing data related to patients, samples, services or special pathogens can be prepared.

A two-hour antibiotic susceptibility test by ATP-bioluminescence.

The antibiotic susceptibility test (AST) in Clinical Microbiology laboratories is still time-consuming, and most procedures take 24h to yield results. In this study, a rapid antimicrobial susceptibility test using ATP-bioluminescence has been developed. The design of method was performed using five ATCC collection strains of known susceptibility. This procedure was then validated against standard commercial methods on 10 strains of enterococci, 10 staphylococci, 10 non-fermenting gram negative bacilli, and 13 Enterobacteriaceae from patients. The agreement obtained in the sensitivity between the ATP-bioluminescence method and commercial methods (E-test, MicroScan and VITEK2) was 100%. In summary, the preliminary results obtained in this work show that the ATP-bioluminescence method could provide a fast and reliable AST in two hours.

Recommendations of the Spanish Antibiogram Committee (COESANT) for in vitro susceptibility testing of antimicrobial agents by disk diffusion.

Disk diffusion is a well standardized method that provides reliable categorical results to guide antimicrobial therapy in numerous types of infections. Based on the guidelines of the European Committee on Antimicrobial Susceptibility Testing (EUCAST), which are widely implemented in Spain, the Spanish Antibiogram Committee (COESANT) has drawn up recommendations for antimicrobial selection by the disk diffusion technique, including selective reporting and its use for the detection of resistance mechanisms. Factors affecting disk diffusion results, along with advantages and shortcomings of the method, are also discussed.

Spanish Antibiogram Committee (COESANT) recommendations for cumulative antibiogram reports.

The Spanish Antibiogram Committee (Comité Español del Antibiograma, COESANT) presents in this document a series of recommendations intending to unify how cumulative antibiogram reports must be made in Clinical Microbiology Spanish laboratories. This article is based on the information included in the Clinical Microbiology Procedure No. 51, «Preparation of cumulative reports on antimicrobial susceptibility¼ of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), published in 2014. The recommendations also include the modifications in the definition of clinical interpretive categories recently published by the European Committee on Antimicrobial Susceptibility Testing (EUCAST) in 2019. Its final objective is to establish a homogeneous way of preparing these summaries to compare results from different centers or aggregate the information from these in order to carry out an adequate local or even national surveillance regarding the evolution of antimicrobial susceptibility.

From CLSI to EUCAST, a necessary step in Spanish laboratories. / Del CLSI al EUCAST, una transición necesaria en los laboratorios españoles.

The Spanish Antibiogram Committee (Comité Español del Antibiograma, COESANT) presents in this document a simple "roadmap" or decalogue of recommendations, with a view to facilitating the transition from the Clinical and Laboratory Standards Institute (CLSI) to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) antimicrobial susceptibility testing regulations to the Clinical Microbiology Spanish laboratories that still use the CLSI guidelines. The objectives are to adapt the closer European regulations to the Spanish clinical and epidemiological reality and to fully implement the EUCAST recommendations in all microbiology laboratories in Spain.

Recommendations of the Spanish Antibiogram Committee (COESANT) for selecting antimicrobial agents and concentrations for in vitro susceptibility studies using automated systems.

Automated antimicrobial susceptibility testing devices are widely implemented in clinical microbiology laboratories in Spain, mainly using EUCAST (European Committee on Antimicrobial Susceptibility Testing) breakpoints. In 2007, a group of experts published recommendations for including antimicrobial agents and selecting concentrations in these systems. Under the patronage of the Spanish Antibiogram Committee (Comité Español del Antibiograma, COESANT) and the Study Group on Mechanisms of Action and Resistance to Antimicrobial Agents (GEMARA) from the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC), and aligned with the Spanish National Plan against Antimicrobial Resistance (PRAN), a group of experts have updated this document. The main modifications from the previous version comprise the inclusion of new antimicrobial agents, adaptation of the ranges of concentrations to cover the EUCAST breakpoints and epidemiological cut-off values (ECOFFs), and the inference of new resistance mechanisms. This proposal should be considered by different manufacturers and users when designing new panels or cards. In addition, recommendations for selective reporting are also included. With this approach, the implementation of EUCAST breakpoints will be easier, increasing the quality of antimicrobial susceptibility testing data and their microbiological interpretation. It will also benefit epidemiological surveillance studies as well as the clinical use of antimicrobials aligned with antimicrobial stewardship programs.

Consenso latinoamericano sobre la importancia de un sistema de gestión de datos microbiológicos para apoyar el programa de optimización de uso de antimicrobianos (PROA): Recomendaciones basadas en la evidencia. Parte 1 / Latin American consensus on the importance of a microbiological data management system to support antimicrobial use optimization program (PROA): Evidence-based recommendations. Part 1

La resistencia antimicrobiana es una amenaza para los logros de la medicina moderna y una de las medidas más efectivas para contrarrestarla son los programas de optimización del uso de antimicrobianos (PROA), en el cual el laboratorio de microbiología es uno de los principales componentes. La aplicación efectiva de tecnología de la información en los procesos es fundamental, pero existe poca información en Latinoamérica sobre el desarrollo y la articulación de las herramientas tecnológicas para apoyar los PROA. Este consenso hace recomendaciones sobre la gestión de los datos microbiológicos para la toma de decisiones. En la Parte I, se presentan las recomendaciones en cuanto al uso de un sistema informatizado de gestión de datos microbiológicos en la práctica clínica, los requerimientos de datos y de reporte en el laboratorio de microbiología, y los contenidos del sistema de gestión de calidad avanzado en el laboratorio. En la Parte II, se discuten los requerimientos de información para la gestión de PROA en estadios intermedios, iniciales y avanzados por el laboratorio y la farmacia; así como la integración del equipo de PROA con el Comité de Prevención y Control de Infecciones y la información para la gestión de PROA a nivel gerencial.

Antimicrobial resistance is a threat to the achievements of modern medicine and one of the most effective measures to counteract it is antimicrobial use optimization programs (AMS), in which the microbiology laboratory is one of the main components. The effective application of information technology in the processes is fundamental, but there is little information in Latin America on the development and articulation of technological tools to support AMSs. This consensus makes recommendations on the management of microbiological data for decision making. In Part I, recommendations on the use of a computerized microbiological data management system in clinical practice, data and reporting requirements in the microbiology laboratory, as well as the contents of the advanced quality management system in the laboratory are presented. In Part II, the information requirements for AMS management in intermediate, initial, and advanced stages by the laboratory and pharmacy are discussed; as well as the integration of the AMS team with the Infection Prevention and Control Committee and the information for AMS management at the management level.

Bacteriuria asintomática en el embarazo. Serie de casos en una clínica privada de Uruapan, Michoacán / Asymptomatic bacteriuria in pregnancy. Cases series in a private clinic in Uruapan Michoacán

Resumen OBJETIVO: Determinar la prevalencia de bacteriuria asintomática, su adecuado tratamiento con base en el reporte del antibiograma de pacientes embarazadas que acudieron a control prenatal en una clínica privada. MATERIALES Y MÉTODOS: Estudio retrospectivo de una serie de casos, descriptivo y transversal efectuado en mujeres embarazadas que acudieron a control prenatal en la consulta externa del Hospital Fray Juan de San Miguel de Uruapan, Michoacán, entre el 1 de enero de 2019 y el 31 de diciembre de 2021. Variables de estudio: edad de las madres, semanas de embarazo, embarazos, bacteriuria, agente causal, antibiótico indicado y respuesta al tratamiento. Para interpretar los resultados obtenidos se aplicaron estadística descriptiva, medidas de tendencia central y de frecuencias simples. RESULTADOS: Se estudiaron 227 embarazadas; de ellas, 49 tuvieron un urocultivo positivo. La prevalencia de bacteriuria asintomática fue de 21.59. Escherichia coli fue el agente causal más reportado. De los urocultivos de control 36 de 37 resultaron negativos y solo 1 de 37 fue positivo. CONCLUSIÓN: La prevalencia de bacteriuria asintomática de este estudio fue de 21.59% y el principal agente etiológico asilado E. coli en la mayoría de los casos, con sensibilidad a nitrofurantoína en la mayoría de los casos.

Abstract OBJECTIVE: To determine the prevalence of asymptomatic bacteriuria, its adequate treatment based on the antibiogram report of pregnant patients who attended prenatal control in a private clinic. MATERIALS AND METHODS: Retrospective study of a case series, descriptive and cross-sectional carried out in pregnant women who attended prenatal control in the outpatient clinic of the Hospital Fray Juan de San Miguel de Uruapan, Michoacán, between January 1, 2019 and December 31, 2021. Study variables: mothers' age, weeks of pregnancy, pregnancies, bacteriuria, causative agent, indicated antibiotic and response to treatment. Descriptive statistics, measures of central tendency and simple frequencies were used to interpret the results obtained. RESULTS: A total of 227 pregnant women were studied; 49 of them had a positive urine culture. The prevalence of asymptomatic bacteriuria was 21.59. Escherichia coli was the most reported causative agent. Of the control urine cultures 36 of 37 were negative and only 1 of 37 was positive. CONCLUSION: The prevalence of asymptomatic bacteriuria in this study was 21.59% and the main etiologic agent was E. coli in most cases, with sensitivity to nitrofurantoin in most cases.

Infección del tracto urinario en el servicio de Pediatría del Hospital Regional de Moquegua / Urinary tract infections in the Pediatric Unit of the Hospital Regional de Moquegua

RESUMEN Objetivo: Determinar el comportamiento clínico epidemiológico de apoyo al diagnóstico terapéutico y susceptibilidad antimicrobiana de infección del tracto urinario (ITU) en hospitalización del servicio de Pediatría del Hospital Regional de Moquegua durante los años 2014-2020. Materiales y métodos: Estudio observacional, descriptivo y retrospectivo. Para el propósito del estudio se tomó en cuenta una población de 248 pacientes, de 1 mes de edad a 14 años con 11 meses y 30 días, con diagnóstico de ITU, a quienes se les realizó un urocultivo. Se utilizó una ficha de recolección de datos y se procesaron los resultados en el programa SPSS versión 23. Resultados: La infección se presentó con más frecuencia en pacientes de sexo femenino (82,26 %) y la fiebre (83,87 %) fue la manifestación clínica predominante. El tratamiento médico que más se utilizó fue la amikacina (49,19 %). El germen que se aisló con mayor frecuencia fue E. coli (70,57 %). Los gérmenes aislados mostraron mayor frecuencia de sensibilidad frente a los antibióticos nitrofurantoina (70,16 %), ceftazidima (51,20 %), gentamicina (43,14 %) y amikacina (28,62 %). Por otro lado, presentaron resistencia frente al sulfametoxazol-trimetropim (74,59 %). Dentro de los hallazgos más comunes sobre estudios de imágenes se encontró la pielectasia unilateral (43,14 %). Conclusiones: La ITU se presenta con mayor frecuencia en mujeres. Es fundamental realizar la anamnesis y el examen clínico y, además, contar con el examen completo de orina y de imágenes. El diagnóstico definitivo se obtendrá vía urocultivo; iniciar el tratamiento de manera empírica dependerá del historial de sensibilidad y resistencia en base a los urocultivos realizados.

ABSTRACT Objective: To determine the clinical and epidemiological characteristics of urinary tract infections (UTIs) supported by the diagnosis, therapy and antimicrobial susceptibility of inpatients of the Pediatric Unit of the Hospital Regional de Moquegua from 2014 to 2020. Materials and methods: An observational, descriptive and retrospective study. The research included a population of 248 patients aged between 1 month and 14 years 11 months 30 days with a diagnosis of UTI who underwent a urine culture. A data collection sheet was used and the results were processed using the IBM SPSS Statistics statistical software 23.0. Results: The infection occurred more often in female patients (82.26 %), with fever being the most prevalent clinical manifestation (83.87 %). The most widely used medical treatment was amikacin (49.19 %). E. coli was the most frequently isolated germ (70.57 %). The isolated germs showed sensitivity to antibiotics such as nitrofurantoin (70.16 %), ceftazidime (51.20 %), gentamicin (43.14 %) and amikacin (28.62 %). In contrast, they were resistant to sulfamethoxazole-trimethoprim (74.59 %). One of the most common findings in the imaging tests was unilateral pyelectasis (43.14 %). Conclusions: UTIs occur more frequently in women. The anamnesis and clinical examination, together with a complete urinalysis and imaging tests, are essential for the diagnosis and treatment of these patients. The definitive diagnosis must be established by a urine culture. The choice of an empirical therapy will depend on the patient's history of sensitivity and resistance to antibiotics based on the urine cultures performed.

Efecto antimicrobiano in vitro de extractos de Caesalpinia Spinosa (algarrobo) sobre patógenos orales / In vitro antimicrobial effect of Caesalpinia Spinosa (carob tree) extracts on oral pathogens

La resistencia antimicrobiana es un problema de sa-lud pública mundial. Las infecciones por microorga-nismos resistentes pueden ser altamente transmisi-bles e incluso causar la muerte. Este hecho genera grandes costos para los pacientes y para los servi-cios de salud. El objetivo del presente trabajo fue de-terminar el efecto antimicrobiano in vitro de extractos etanólicos de Caesalpinia spinosa sobre el crecimien-to de Enterococcus faecalis, Staphylococcus aureus y Candida albicans. Se recolectaron y certificaron muestras de C. spinosa. Se obtuvieron extractos de hojas, vainas y semillas en concentraciones de 100%, 75%, 50% y 25%. Mediante Kirby - Bauer, se cargaron los discos con los extractos y se depositaron en el medio inoculado con cepas de E. faecalis, S. aureus y C. albicans; junto a un CP (antimicrobiano), y un CN (etanol). Las placas se incubaron a 370°C durante 24 horas, y posteriormente se midieron los halos de inhi-bición con un vernier digital. Destaca el valor del halo de extracto de vainas; superó al de Ampicilina 10mg, sobre el E. faecalis. El extracto de vainas presentó ma-yor diámetro de inhibición (19mm), el de semillas pre-sentó el más bajo (1mm). ANOVA arrojó diferencia es-tadísticamente significativa entre los datos obtenidos para todos los extractos. En conclusión, los extractos etanólicos de Caesalpinia spinosa tienen efecto anti-microbiano in vitro sobre Enterococcus faecalis, Sta-phylococcus aureus y Candida albicans. La actividad antimicrobiana del extracto es directamente propor-cional a su concentración. Los extractos de C. spinosa podrían ser utilizados como coadyuvantes en el trata-miento contra Enterococcus faecalis, Staphylococcus aureus, Candida albicans, que están relacionados con patologías orales (AU)

Antimicrobial resistance is a global public health problem. Infections with resistant microorganisms can be highly transmissible and even cause death. This fact generates great costs for patients and for health services. The objective of this work was to determine the in vitro antimicrobial effect of ethanolic extracts of Caesalpinia spinosa on the growth of Enterococcus faecalis, Staphylococcus aureus and Candida albicans. Samples of C. spinosa were collected and certified. Leaf, pod and seed extracts were obtained at concentrations of 100%, 75%, 50% and 25%. Using Kirby-Bauer, the disks were loaded with the extracts and deposited in the medium inoculated with strains of E. faecalis, S. aureus and C. albicans; together with a CP (antimicrobial), and a CN (ethanol). The plates were incubated at 370°C for 24 hours, then the inhibition halos were measured with a digital vernier. The value of the pod extract halo stands out, surpassing that of Ampicillin 10mg, over E. faecalis. The pod extract presented the greatest diameter of inhibition (19mm), the seed extract presented the lowest (1mm). ANOVA showed a statistically significant difference between the data obtained for all the extracts. In conclusion, the ethanolic extracts of Caesalpinia spinosa have an in vitro antimicrobial effect on Enterococcus faecalis, Staphylococcus aureus and Candida albicans. The antimicrobial activity of the extract is directly proportional to its concentration. C. spinosa extracts could be used as adjuvants in the treatment against Enterococcus faecalis, Staphylococcus aureus, Candida albicans, which are related to oral pathologies (AU)

Perfil de sensibilidade a antibióticos de um isolado de Providencia rettgeri proveniente de equino / Antibiotic sensitivity profile in isolate of Providencia rettgeri from a horse

Introdução: a meningite bacteriana em equinos é uma enfermidade frequente em animais jovens. Streptococcus spp., Staphylococcus aureus e Escherichia coli são as bactérias mais comumente isoladas nesses casos. Apesar da bactéria Providencia rettgeri já ter sido isolada em casos de meningite humana e de crocodilo, não há relatos de seu isolamento em equinos. Objetivo: relatar o isolamento e a identificação da bactéria P. rettgeri de um potro com sintomas neurológicos e avaliar o perfil de sensibilidade a antibióticos deste isolado. Metodologia: o isolamento foi realizado a partir do líquido cefalorraquidiano do potro, por meio de cultivo em meio ágar chocolate. Após isolamento, as colônias formadas foram identificadas por equipamento Biotyper, baseado em espectrometria de massa. O perfil de sensibilidade foi definido por teste de difusão em discos, seguindo metodologia relatada pelo CLSI M2-A8 em 2003, sendo a bactéria classificada como resistente, padrão indeterminado ou sensível aos antibióticos, de acordo com o descrito pelo EUCAST em 2021. Resultados: este é o primeiro relato do isolamento de P. rettgeri como agente etiológico de meningite em potro. Dos 15 antibióticos testados, a bactéria foi resistente a 9, sensível a 5 e com padrão indeterminado a 1 antibiótico. Conclusão: nossos resultados indicam que P. rettgeri deve ser considerada entre possíveis agentes etiológicos de quadros neurológicos em equinos e que testes de sensibilidade a antibiótico são fundamentais, uma vez que essa bactéria já apresenta resistência a diversos antibióticos disponíveis comercialmente.

Introduction: Bacterial meningitis in horses is a frequent disease in young animals. Streptococcus spp., Staphylococcus aureus and Escherichia coli are the most commonly isolated bacteria in these cases. Although Providencia rettgeri bacterium has already been isolated in cases of human and crocodile meningitis, there are no reports of its isolation in cases of meningitis in horses. Objective: to report isolation and identification of the P. rettgeri bacteria from a foal with neurological symptoms and to assess antibiotic sensitivity profile in isolate of it. Methods: isolation was performed from the foal's cerebrospinal fluid, through cultivation in chocolate agar medium. After isolation, formed colonies were identified by Biotyper equipment, based on mass spectrometry. Sensitivity profile was verified by disk diffusion test, according to methodology that was reported by CLSI M2-A8 in 2003, which classified bacteria as resistant, indeterminate pattern or sensitive to antibiotics, as described by EUCAST in 2021. Results: this is the first report on isolation of P. rettgeri as an etiologic agent of meningitis in foals. Among 15 antibiotics that were tested, results showed bacteria resistence to 9 antibiotics, bacteria sensitivity to 5, but undetermined pattern to 1 antibiotic. Conclusion: results indicate that P. rettgeri shall be considered among potential etiologic agents of neurological conditions in horses and that antibiotic sensitivity tests are essential, since this type of bacterium is already resistant to several commercially available antibiotics.

Efecto antibacteriano in vitro de extractos de Caesalpinia spinosa sobre cepas de Staphylococcus aureus resistentes a antibióticos betalactámicos / In vitro antimicrobial effect of Caesalpinia spinosa extracts against betalactam antibiotics resistant Staphylococcus aureus strains

Objetivo. Determinar el efecto antimicrobiano de extractos etanólicos de Caesalpinia spinosa sobre cepas de Staphylococcus aureus penicilino y meticilino resistentes. Métodos. Se utilizaron las cepas de S. aureus ATCC 11632 y 33592, los extractos etanólicos de hojas, vainas y semillas de C. spinosa, se obtuvieron por maceración en concentraciones de 25%, 50%, 75% y 100%. Se utilizó el método de Kirby-Bauer, los discos de papel filtro se cargaron con los extractos y se depositaron sobre el medio, inoculado con una suspensión de S. aureus a 0,5 McFarland. El control positivo fueron discos de ampicilina y el control negativo discos impregnados con etanol. Después de 24 horas se midieron los diámetros de los halos con un calibrador Vernier. Resultados. Se registraron halos de hasta 18 mm de diámetro con los extractos de hojas al 100%, 17 mm con extractos de vainas y 14 mm con extractos de semillas sobre S. aureus ATCC 33592. En el caso de la cepa ATCC 11632, se registraron halos de hasta 14 mm con extractos de hojas y vainas al 100%, y de hasta 8 mm con extractos de semillas. La prueba de ANOVA indicó que existieron diferencias significativas entre los halos obtenidos con los diferentes tipos de extractos, a diferentes concentraciones. Conclusión. Se determinó que todos los extrac- tos de C. spinosa poseen actividad antimicrobiana sobre las dos cepas estudiadas, con un patrón directamente proporcional entre el efecto y la concentración.

Objective. To determine the antimicrobial effect of ethanolic extracts from Caesalpinia spinosa against penicillin and methicillin resistant strains of Staphylococcus aureus penicillin and methicillin. Methods. S. aureus ATCC 11632 and 33592 strains were used, ethanolic extracts from C. spinosa leaves and pods were obtained by maceration at concentrations of 25%, 50%, 75% and 100%. The Kirby-Bauer method was used, where filter paper discs were loaded with leaf, pod and seed extracts and deposited on the medium, inoculated with a 0.5 McFarland suspension of S. aureus. Ampicillin discs were used as positive con- trol and ethanol-impregnated discs as negative control. After 24 hours, the diameters of the halos were measured with a Vernier caliper. Results. Haloes up to 18 mm in diameter with 100% leaf extracts, 17 mm with pod extracts and 14 mm with seed extracts were recorded against S. aureus ATCC 33592; for ATCC strain 11632, haloes up to 14 mm with 100% leaf and pod extracts and up to 8 mm with seed extracts were recorded. The ANOVA test indicated significant differences between the inhibition halos obtained with the different types of extracts, at different concentrations. Conclusion. It was determined that all C. spinosa extracts possess antimicrobial activity against the two strains studied, with a pattern directly proportional between the effect and concentration.

Investigation of the effects of some phytochemicals on Yersinia ruckeri and antimicrobial resistance / Investigação dos efeitos de alguns fitoquímicos em Yersinia ruckeri e resistência antimicrobiana

Abstract In this study, it is aimed to investigate the effects of Moringa oleifera and Sorbus domestica plant extracts on bacterial disease agents Yersinia ruckeri in aquaculture. Morphological and biochemical properties of 2 different Y. ruckeri isolates were determined. Then, Real-Time PCR analysis and gene sequencing of the isolates were identified. Phytochemicals (M. oleifera and S. domestica) and antibiotics (Oxytetracycline (OX) and Enrofloxacin (ENR)) were used together in the antibiogram test of antibiotics compared to the effect status of antibiotics. Also, the effects of phytochemicals on Y. ruckeri growth was examined comparatively by spectrophotometrically measuring at 600 nm wavelength every 2 hours according to bacterial growth densities with 10 different groups formed on TSB medium. As a result of the study, it was observed that the isolates formed Gram negative, catalase positive, oxidase negative, mobile and typical Y. ruckeri colonies. After the biochemical tests performed with Microgen ID panel, 99.85% similarity was determined. The isolates overlap with the 16S rRNA gene region after sequence analysis, and 99% of the isolates were similar in phylogenetic analysis. After the antibiogram test, Oxytetracycline and Enrofloxacin antibiotics were resistant to Y. ruckeri but the effects of phytochemicals were less on solid medium (MHA). As a result of the measurements carried out in liquid medium (TSB), it was observed that phytochemicals such as M. oliefera and S. domestica inhibit the growth of bacteria by 40-50%. As the importance of antibiotic resistance is increasing day by day, we believe that these phytochemicals will give positive results in treatment instead of using antibiotics.

Resumo Neste estudo, objetiva-se investigar os efeitos dos extratos de plantas de Moringa oleifera e Sorbus domestica sobre agentes bacterianos Yersinia ruckeri na aquicultura. Foram determinadas as propriedades morfológicas e bioquímicas de 2 isolados diferentes de Y. ruckeri. Em seguida, a análise de PCR em tempo real e o seqüenciamento genético dos isolados foram identificados. Fitoquímicos (M. oleifera e S. domestica) e antibióticos (Oxitetraciclina e Enrofloxacina) foram usados ​​juntos no teste de antibiograma dos antibióticos em comparação com o status de efeito dos antibióticos. Além disso, os efeitos dos fitoquímicos no crescimento de Y. ruckeri foram examinados comparativamente por medição espectrofotométrica no comprimento de onda de 600 nm a cada 2 horas de acordo com as densidades de crescimento bacteriano com 10 grupos diferentes formados no meio TSB. Como resultado do estudo, observou-se que os isolados formaram colônias Gram-negativas, catalase-positivas, oxidase-negativas, móveis e típicas de Y. ruckeri. Após os testes bioquímicos realizados com o painel Microgen ID, foi determinada uma similaridade de 99,85%. Os isolados se sobrepõem à região do gene 16S rRNA após a análise da sequência e 99% dos isolados foram semelhantes na análise filogenética. Após o teste do antibiograma, os antibióticos Oxitetraciclina e Enrofloxacina foram resistentes a Y. ruckeri, mas os efeitos dos fitoquímicos foram menores no meio sólido (MHA). Como resultado das medições realizadas em meio líquido (TSB), observou-se que os fitoquímicos inibem o crescimento de bactérias em 40-50%. Como a importância da resistência aos antibióticos está aumentando dia a dia, acreditamos que as plantas que são mais alternativas e mais adequadas para o uso de antibióticos hoje em dia darão resultados positivos no tratamento.

Validación de un dispositivo point-of-care para la detección rápida de infección urinaria y susceptibilidad antimicrobiana / Validation of point-of-care device for rapid detection of urinary tract infection and antibiotic susceptibility

Resumen Introducción: Las infecciones del tracto urinario (ITU) presentan una elevada prevalencia en el ámbito comunitario. Un rápido diagnóstico microbiológico es esencial para asegurar una terapia adecuada y efectiva. Objetivo: Evaluar un kit de antibiograma rápido (KAR®) en formato point-of-care para la detección rápida de ITU y sensibilidad antimicrobiana. Material y Métodos: El dispositivo KAR® se diseñó y desarrolló en colaboración con ingenieros técnicos y microbiólogos clínicos. Su evaluación se realizó a través de un estudio multicéntrico en el que participaron tres hospitales españoles. Para ello, se realizaron distintos ensayos in vivo con el fin de determinar la correlación del dispositivo con las técnicas microbiológicas de referencia. Resultados: Se ensayó un total de 400 muestras de orinas procedentes de pacientes con sospecha de ITU. El dispositivo KAR® proporcionó rápidos resultados (tiempo medio de positividad de 7,8 ± 1,5 h) con 97% de sensibilidad, 89% de especificidad y 87% de concordancia para la detección de bacteriuria significativa. Los porcentajes de especificidad para los antimicrobianos testados fueron: ciprofloxacina (97%), fosfomicina (94%), cotrimoxazol (84%), ampicilina (80%) y amoxicilina/ácido clavulánico (55%). Conclusión: El dispositivo KAR® puede ser una herramienta útil para el diagnóstico de ITU en pacientes ambulatorios, especialmente en áreas de bajo nivel socio-económico.

Abstract Background: Urinary tract infections (UTI) presents a high prevalence in the community setting. Rapid and accurate microbiological diagnosis is essential to ensure adequate and effective therapy. Aim: To evaluate a rapid antibiogram kit (KAR®) in point-of-care format for rapid detection of UTI and antibiotic susceptibility. Methods: The KAR® device has been designed and developed in collaboration with technical engineers and clinical microbiologists. Its evaluation has been carried out through a multicenter study in which three Spanish hospitals have participated. Thus, different in vivo tests have been implemented in order to determine device correlation with the reference microbiological techniques. Results: During the study period, a total of 400 urine samples from patients with suspected ITU were tested. The KAR® device provided fast results (mean positivity time of 7,8 ± 1,5 hours) with 97% sensitivity, 89% specificity and 87% agreement for the detection of significant bacteriuria. The percentages of specificity for the antibiotics tested were: ciprofloxacin (97%), fosfomycin (94%),cotrimoxazole (84%), ampicillin (80%) and amoxicillin/clavulanic acid (55%). Conclusion: The KAR® device could be a useful tool for diagnosing UTI in outpatients, especially in areas of low socio-economic level.

Levantamento de agentes causadores de mastite e sua resistência a antibióticos / Survey agents of mastitis causes and their resistance to antibiotics

Dentre as enfermidades que acometem o rebanho leiteiro a mastite é a que apresenta o maior impacto econômico, assim com o objetivo de identificar os agentes causadores de mastite e de avaliar a sua resistência a antibióticos, analisou-se 119 amostras de leite, coletadas de 47 unidades produtoras distribuídas em 10 municípios da microrregião de Pelotas no RS. Das amostras analisadas, 76,7% agentes foram classificados como Gram positivos (G+) e 23,3% como Gram negativos (G-) . Das amostras G+ analisados, os que obtiveram maior resistência por parte dos microrganismos isolados, classificados como Gram positivos, foram trimetropin (70% ), seguido da penicilina (65,2%). Já os antimicrobianos com maior resistência por parte dos isolados de G-, foram cefalotina (85,7%), seguido de trimetropin (80,9%). Por fim, as 16 amostras de Staphylococcus coagulase positiva, foram 100% resistentes a estreptomicina. Verifica-se assim a importância de um adequado manejo para o correto uso dessas drogas.

Tratamiento de la infección del tracto urinario en pacientes con diabetes e insuficiencia renal / Treatment of urinary tract infection in patients wiht diabetes and renal insufficiency

El tratamiento de la infección del tracto urinario (ITU) en pacientes con diabetes mellitus (DM) depende de factores como la presencia de síntomas, de anormalidades urológicas, el nivel anatómico, la severidad de la ITU y la función renal. Como regla general el tratamiento de la ITU en pacientes con DM es similar al tratamiento de los pacientes sin DM. La elección del antibiótico deberá guiarse, además de las características del paciente, por los patrones de resistencia local a los uropatógenos. No existe indicación para tratar la bacteriuria asintomática en el paciente con diabetes. Siempre que sea posible la terapia antimicrobiana debe retrasarse a la espera de los resultados del urocultivo y antibiograma para que la terapia pueda dirigirse al agente patógeno específico. No está avalado que los pacientes con diabetes deban recibir tratamientos más prolongados. Conviene realizar ajuste de dosis de antimicrobianos en pacientes con deterioro del filtrado glomerular; en estos casos no elegir esquemas con drogas nefrotóxicas como los aminoglucósidos

The treatment of urinary tract infections (UTI) in patients with diabetes mellitus (DM) depends on factors such as the presence of symptoms, urological abnormalities, anatomical level, severity of UTI and renal function. As a rule, the treatment of UTI in patients with DM is similar to the treatment of patients without DM. The choice of antibiotic should be guided, in addition to the characteristics of the patient, by the patterns of local resistance to uropathogens. There is no indication to treat asymptomatic bacteriuria in patients with diabetes. Whenever antimicrobial therapy is possible, it should be delayed awaiting the urine culture results and antibiogram so that therapy can be directed to the specific pathogen. It is not supported that patients with diabetes should receive longer treatments. It is advisable to perform dose adjustment of antimicrobials in patients with impaired glomerular filtration; in these cases, schemes with nephrotoxic drugs such as aminoglycosides should not be chosen