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Texto completo SciELO Chile
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Id: biblio-991369
Autor: Aravena, Carmen; Valencia, Bárbara; Villegas, Andrea; Ortega, Mauricio; Fernández R, Alda; Araya R, Pamela; Saavedra, Aníbal; Del Campo, Rosa.
Título: Caracterización de cepas clínicas y ambientales de Salmonella enterica subsp. enterica serovar Heidelberg aisladas en Chile / Characterization of Salmonella Heidelberg strains isolated in Chile
Fonte: Rev. méd. Chile;147(1):24-33, 2019. tab.
Idioma: es.
Projeto: Dirección de Investigación Universidad de Valparaíso.
Resumo: Background: Salmonella Heidelberg (S. Heidelberg) causes gastroenteritis and sometimes bacteremia and endocarditis. In other countries, this serovar has multidrug resistance including extended-spectrum β-lactamases (ESBLs) and AmpC (β-lactamases (AmpC), associated with the blaCMY-2 gene. In Chile, an outbreak by S. Heidelberg occurred in 2011, the phenotypic and genetic characteristics of Chilean strains are unknown. Aim: To determine the antimicrobial susceptibility, presence of plasmids and virulence factor genes in S. Heidelberg strains isolated in Chile over the period 2006-2011. Material and Methods: In sixty-one S. Heidelberg clinical and environmental strains collected by the Public Health Institute in Chile during 2006-2011, antimicrobial susceptibility, plasmids and virulence factor genes (invA, sifA, pefA, agfA, lpfA and, stkD) were studied. Results: S. Heidelberg had a high susceptibility to sulfamethoxazole-trimethoprim, gentamicin, ceftriaxone, ceftiofur, chloramphenicol, amoxicillin-clavulanic acid and ampicillin. However, 52% had decreased susceptibility to ciprofloxacin and 33% resistance to tetracycline. ESBLs were detected in three strains isolated from blood cultures, environment and human feces. The latter strain was positive for AmpC and blaCMY-2 gene. Fifty three of 61 strains showed one to seven plasmids of 0.8 to approximately 30 kb. Most plasmids were small with sizes between 0.8 and 2 kb. All isolates were positive for all genes except pefA. Conclusions: S. Heidelberg isolated from Chilean samples was susceptible to first-line antimicrobials, except tetracycline and ciprofloxacin. The emergence of strains with ESBLs and AmpC should be a warning. The strains were homogeneous for virulence genes, but heterogeneous in their plasmids.
Descritores: Plasmídeos/isolamento & purificação
Salmonella/isolamento & purificação
Salmonella/efeitos dos fármacos
Antibacterianos/farmacologia
-Valores de Referência
Salmonella/genética
Salmonella/patogenicidade
Fatores de Tempo
Virulência
DNA Bacteriano
Testes de Sensibilidade Microbiana
Chile
Eletroforese em Gel de Campo Pulsado
Farmacorresistência Bacteriana Múltipla
Microbiologia Ambiental
Limites: Humanos
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-844402
Autor: Kappes, Tomás; Domínguez, Mariana; Bello-Toledo, Helia; Mella Montecinos, Sergio; Riedel Molina, Gisella; González-Rocha, Gerardo.
Título: Actividad de cobre sobre cocáceas grampositivas multi-resistentes a los antibióticos aisladas en hospitales chilenos / Copper activity against multiresistant Gram-positive cocci isolated in Chilean hospitals
Fonte: Rev. chil. infectol;33(5):519-523, oct. 2016. graf, tab.
Idioma: es.
Resumo: Background: Nosocomial infections caused by multiresistant Gram-positive cocci are a serious problem for public health systems worldwide. The use of copper surfaces in hospital environments has proven to be an effective alternative for the control of various microorganisms, including multiresistant nosocomial pathogens. Aim: To determine the association between antibiotic multiresistance and higher levels of copper tolerance in Gram-positive cocci isolated from Chilean hospitals, which might confer a selective advantage in environments with copper. Methods: The ionic copper tolerance levels were evaluated using the Mueller Hinton agar dilution method, in S. aureus and Enterococcus spp. strains with different levels of susceptibility to clinically relevant antibiotics. Results: A statistically significant association between higher levels of tolerance to copper ion and multi-resistance to antibiotics in Enterococcus spp. was observed.

Introducción: Las infecciones nosocomiales, producidas por bacterias cocáceas grampositivas multi-resistentes constituyen un serio problema para los sistemas de salud pública mundial. El uso de superficies de cobre en ambientes hospitalarios ha demostrado ser una alternativa efectiva para el control de diversos microorganismos, incluyendo patógenos nosocomiales multi-resistentes. Objetivo: Determinar la asociación entre la multi-resis-tencia a antimicrobianos y mayores niveles de tolerancia a cobre en bacterias cocáceas grampositivas aisladas de hospitales chilenos, que podrían conferir una ventaja selectiva en ambientes cobrizados. Material y Métodos: Se evaluó los niveles de tolerancia a cobre iónico en grupos de cepas de Staphylococcus aureus y Enterococcus spp. con distintos grados de susceptibilidad a antimicrobianos de relevancia clínica, mediante el método de dilución en agar Mueller Hinton. Resultados: Se observó una asociación estadísticamente significativa entre mayores niveles de tolerancia a cobre iónico y la multi-resistencia a antimicrobianos en Enterococcus spp.
Descritores: Staphylococcus aureus/efeitos dos fármacos
Enterococcus/efeitos dos fármacos
Cobre/farmacologia
Antibacterianos/farmacologia
-Testes de Sensibilidade Microbiana
Chile
Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos
Limites: Humanos
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1280329
Autor: Lemus Molina, Dihadenys; Echemendía Font, Miguel; Díaz Rodríguez, Raúl; Rodríguez Estévez, Delimary; Martínez Rodríguez, Alina; Suárez Álvarez, Lourdes; Marrero Figueroa, Antonio.
Título: Resistencia a fármacos antituberculosos en Cuba, 2015-2017 / Resistance to tuberculosis drugs in Cuba, 2015-2017
Fonte: Rev. cuba. med. trop;73(1):e590tab.
Idioma: es.
Resumo: Introducción: La tuberculosis persiste como un importante problema de salud mundial. En el 2016 se estimaron 600 000 casos de resistente a rifampicina, y entre estos 490 000 casos multidrogorresistentes. Objetivo: Describir el comportamiento de la resistencia de los aislados de M. tuberculosis de pacientes con tuberculosis pulmonar notificados en Cuba entre los años 2015-2017. Métodos: Se determinó la susceptibilidad a isoniacida y rifampicina mediante el método de la nitratasa. A los aislados resistentes a rifampicina/multidrogorresistentes se les determinó mediante el método proporcional la susceptibilidad a ofloxacina, kanamicina, amikacina y capreomicina. Resultados: El 93,2 por ciento de los aislados fueron sensibles a isoniacida y rifampicina. En 39 se identificó resistencia a isoniacida y 23 fueron resistente a rifampicina. Se identificaron 10 multidrogorresistentes. No se detectó resistencia a fármacos de segunda línea. Conclusiones: Los resultados alertan sobre la necesidad de investigar las causas que han conllevado al incremento de la tuberculosis resistente en Cuba(AU)

Introduction: Tuberculosis continues to be an important health problem worldwide. In the year 2016, as many as 600 000 cases of rifampicin resistance were estimated, among which 490 000 were multi-drug resistant. Objective: Describe the behavior of resistance to M. tuberculosis isolates in patients with pulmonary tuberculosis reported in Cuba in the period 2015-2017. Methods: Susceptibility to isoniazid and rifampicin was determined by the nitratase method. Susceptibility of rifampicin resistant / multi-drug resistant isolates to ofloxacin, kanamycin, amikacin and capreomycin was determined by the proportional method. Results: Of the isolates analyzed, 93.2 percent were sensitive to isoniazid and rifampicin. Isoniazid resistance was identified in 39 and 23 were rifampicin resistant. Ten multi-drug resistant isolates were identified. Resistance to second line drugs was not detected. Conclusions: Results warn about the need to study the factors leading to the increase in resistant tuberculosis in Cuba(AU)
Descritores: Tuberculose Resistente a Múltiplos Medicamentos/prevenção & controle
Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos
Limites: Humanos
Responsável: CU1.1 - Biblioteca Médica Nacional


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Id: biblio-1045604
Autor: Kurup, R; George, C.
Título: Detection of drug resistant Mycobacterium tuberculosis among patients with and without HIV infection in a rural setting / Detección de Mycobacterium tubersulosis resistente a los antibióticos entre pacientes con y sin infección por VIH en un área rural
Fonte: West Indian med. j;62(2):122-126, Feb. 2013. ilus, tab.
Idioma: en.
Resumo: OBJECTIVE: To analyse the sensitivity of Mycobacterium tuberculosis by nitrate reductase assay (NRA) and the Hain molecular line probe assay (LPA) in sputa of tuberculosis (TB)/HIV co-infected patients in Guyana. DESIGN: Sputum samples were collected from known TB patients at Georgetown Chest Clinic and were analysed at the Reference Laboratory, Guyana, over the period April 2010 to April 2011. RESULTS: Both methods recorded greater sensitivity for rifampin (RIF) than of isoniazid (INH). Both methods detected four RIF resistant, two INH resistant and two multi-drug resistant (MDR) strains and they had greater negative agreement indices than positive agreement indices. CONCLUSION: It was established that the sensitivity of Mycobacterium tuberculosis by the NRA and Hain LPA in TB/HIV co-infected patients has acceptable correlation and that HIV infection does not affect drug susceptibility testing.

OBJETIVO: Analizar la sensibilidad de Mycobacterium tuberculosis por medio del ensayo de nitrato reductasa (NRA) y el ensayo de sonda lineal (LPA) molecular de Hain en esputos de pacientes co-infectados TB/VIH en Guyana. DISEÑO: Muestras de esputo de pacientes de la Clínica del Tórax en Georgetown diagnosticados con tuberculosis, fueron analizadas en el Laboratorio de Referencias, en Guyana, en el período de abril de 2010 a abril de 2011. RESULTADOS: Ambos métodos registraron una mayor sensibilidad a la rifampicina (RIF) que a la isoniacida (INH). Ambos métodos detectaron cuatro cepas resistentes a RIF, dos resistentes a INH, y dos resistentes a mútiples medicamentos (RMM). Asimismo, presentaban mayores índices de concordancia negativa que de concordancia positiva. CONCLUSIÓN: Se estableció que la sensibilidad de Mycobacterium tuberculosis por medio del ensayo de NRA y el LPA de Hain en pacientes co-infectados TB/VIH, guarda una correlación aceptable, y que la infección por VIH no afecta la prueba de susceptibilidad a los medicamentos.
Descritores: Escarro/microbiologia
Testes de Sensibilidade Microbiana
Infecções por HIV
Mycobacterium tuberculosis/efeitos dos fármacos
Antituberculosos/farmacologia
-Rifampina/farmacologia
População Rural
Tuberculose Pulmonar/microbiologia
Tuberculose Resistente a Múltiplos Medicamentos/microbiologia
Farmacorresistência Bacteriana Múltipla
Coinfecção/microbiologia
Guiana
Isoniazida/farmacologia
Nitratos
Limites: Humanos
Responsável: BR1.1 - BIREME


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Texto completo SciELO Brasil
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Id: biblio-1039534
Autor: Rossi, Flavia; Girardello, Raquel; Morais, Carlos; Cury, Ana Paula; Martins, Layla Farage; da Silva, Aline Maria; Abdala, Edson; Setubal, João Carlos; da Silva Duarte, Alberto José.
Título: Plasmid-mediated mcr-1 in carbapenem-susceptible Escherichia coli ST156 causing a blood infection: an unnoticeable spread of colistin resistance in Brazil?
Fonte: Clinics;72(10):642-644, Oct. 2017.
Idioma: en.
Resumo: OBJECTIVE: We describe an IncX4 pHC891/16mcr plasmid carrying mcr-1 in a colistin-resistant and carbapenem-susceptible E. coli isolate (HC891/16), ST156, which caused a blood infection in a Brazilian patient with gallbladder adenocarcinoma. METHODS: Strain HC891/16 was subjected to whole genome sequencing using the MiSeq Platform (Illumina, Inc., USA). Assembly was performed using Mira and ABACAS. RESULTS: The isolates showed resistance only to ciprofloxacin, ampicillin and cefoxitin, and whole-genome sequencing revealed the presence of aac(6')Ib-cr and blaTEM1. CONCLUSION: Our findings warn of the possible silent dissemination of colistin resistance by carbapenem-susceptible mcr-1 producers, as colistin susceptibility is commonly tested only among carbapenem-resistant isolates.
Descritores: Carbapenêmicos/farmacologia
Bacteriemia/tratamento farmacológico
Colistina/farmacologia
Proteínas de Escherichia coli/efeitos dos fármacos
Escherichia coli/efeitos dos fármacos
Antibacterianos/farmacologia
-Plasmídeos/efeitos dos fármacos
Brasil
Testes de Sensibilidade Microbiana
Proteínas de Escherichia coli/isolamento & purificação
Proteínas de Escherichia coli/genética
Farmacorresistência Bacteriana Múltipla
Escherichia coli/isolamento & purificação
Escherichia coli/genética
Infecções por Escherichia coli/tratamento farmacológico
Limites: Humanos
Feminino
Idoso
Tipo de Publ: Relatos de Casos
Responsável: BR1.1 - BIREME


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Texto completo SciELO Chile
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Id: biblio-899761
Autor: Acuña, M. Paz; Cifuentes, Marcela; Silva, Francisco; Rojas, Álvaro; Cerda, Jaime; Labarca, Jaime.
Título: Incidencia de bacterias multi-resistentes en unidades de cuidados intensivos de hospitales chilenos / Incidence of multi-resistant bacteria in Intensive Care Units of Chilean hospitals
Fonte: Rev. chil. infectol;34(6):570-575, dic. 2017. tab, graf.
Idioma: es.
Resumo: Resumen Introducción: La vigilancia de incidencia de bacterias multi-resistentes es un indicador que permite estimar mejor la magnitud de la resistencia bacteriana en los servicios hospitalarios. Objetivo: Evaluar la incidencia de bacterias multi-resistentes relevantes en unidades de cuidados intensivos del país y establecer las diferencias entre población adulta y pediátrica. Metodología: Se solicitó a los hospitales participantes información del número de aislados de siete bacterias multi-resistentes epidemiológicamente relevantes de unidades de cuidados intensivos (UCI) de adulto y pediátrico entre enero de 2014 y octubre de 2015, y el número de días-cama ocupados en dichas unidades en el mismo período. Con estos datos se calculó incidencia por 1.000 pacientes-día para cada unidad. Resultados: Se recibió información de 20 UCI adultos y 9 UCI pediátricas. En UCI adultos las bacterias de mayor incidencia fueron K. pneumoniae productora de BLEE [4,72 × 1.000 días cama (1,21-13,89)] y S. aureus resistente a oxacilina [3,85 (0,71-12,66)]. En pediatría la incidencia fue menor, destacando K. pneumoniae productora de BLEE [2,71 (0-7,11)] y P. aeruginosa resistente a carbapenémicos [1,61 (0,31-9,25)]. Conclusión: Se observan importantes diferencias entre los distintos hospitales en la incidencia de las bacterias estudiadas. La incidencia de bacterias multi-resistentes en UCI de adultos es significativamente mayor que en UCI pediátrica para la mayoría de las bacterias estudiadas.

Introduction: Incidence of multi-resistant bacteria is an indicator that permits better estimation of the magnitude of bacterial resistance in hospitals. Aim: To evaluate the incidence of relevant multi-drug resistant bacteria in intensive care units (ICUs) of Chile. Methods: Participating hospitals submitted information about the number of isolates from infected or colonized patients with 7 epidemiologically relevant multi-resistant bacteria in adult and pediatric ICUs between January 1, 2014 and October 31, 2015 and the number of bed days occupied in these units in the same period was requested. With these data incidence was calculated per 1,000 patient days for each unit. Results: Information from 20 adults and 9 pediatric ICUs was reviewed. In adult ICUs the bacteria with the highest incidence were K. pneumoniae ESBL [4.72 × 1,000 patient day (1.21-13.89)] and oxacillin -resistant S. aureus [3.85 (0.71-12.66)]. In the pediatric units the incidence was lower, highlighting K. pneumoniae ESBL [2.71 (0-7.11)] and carbapenem -resistant P. aeruginosa [1.61 (0.31-9.25)]. Conclusion: Important differences between hospitals in the incidence of these bacteria were observed. Incidence of multi-resistant bacteria in adult ICU was significantly higher than in pediatric ICU for most of the studied bacterias.
Descritores: Bactérias/isolamento & purificação
Bactérias/efeitos dos fármacos
Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos
Unidades de Terapia Intensiva/estatística & dados numéricos
Antibacterianos/farmacologia
-Valores de Referência
beta-Lactamases/isolamento & purificação
beta-Lactamases/efeitos dos fármacos
Chile
Infecção Hospitalar/microbiologia
Incidência
Limites: Humanos
Criança
Adulto
Responsável: CL1.1 - Biblioteca Central


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Id: lil-776530
Autor: Schuelter-Trevisol, Fabiana; Schmitt, Graciane Jacinta; Araújo, Jane Martins de; Souza, Liliane Braga de; Nazário, Juliana Gomes; Januário, Raquel Landuchi; Mello, Rogério Sobroza de; Trevisol, Daisson José.
Título: New Delhi metallo-beta-lactamase-1-producing Acinetobacter spp. infection: report of a survivor
Fonte: Rev. Soc. Bras. Med. Trop;49(1):130-134, Jan.-Feb. 2016. tab.
Idioma: en.
Resumo: Abstract: New Delhi metallo-beta-lactamase-1 (NDM-1) is a bacterial enzyme that renders the bacteria resistant to a variety of beta-lactam antibiotics. A 20-year-old man was hospitalized several times for surgical treatment and complications caused by a right-sided vestibular schwannoma. Although the patient acquired several multidrug-resistant infections, this study focuses on the NDM-1-producing Acinetobacter spp. infection. As it was resistant to all antimicrobials tested, the medical team developed a 20-day regimen of 750mg/day metronidazole, 2,000,000IU/day polymyxin B, and 100mg/day tigecycline. The treatment was effective, and the patient recovered and was discharged from the hospital.
Descritores: Acinetobacter/enzimologia
beta-Lactamases
Infecções por Acinetobacter/microbiologia
Infecção Hospitalar/microbiologia
Farmacorresistência Bacteriana Múltipla
Antibacterianos/uso terapêutico
-Acinetobacter/efeitos dos fármacos
Infecções por Acinetobacter/tratamento farmacológico
Testes de Sensibilidade Microbiana
Infecção Hospitalar/tratamento farmacológico
Resultado do Tratamento
Antibacterianos/farmacologia
Limites: Humanos
Masculino
Adulto Jovem
Tipo de Publ: Relatos de Casos
Responsável: BR1.1 - BIREME


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Id: lil-782106
Autor: Hosseinkhani, Faride; Jabalameli, Fereshteh; Banar, Maryam; Abdellahi, Nafiseh; Taherikalani, Morovat; Leeuwen, Willem B. van; Emaneini, Mohammad.
Título: Monoterpene isolated from the essential oil of Trachyspermum ammi is cytotoxic to multidrug-resistant Pseudomonas aeruginosa and Staphylococcus aureus strains
Fonte: Rev. Soc. Bras. Med. Trop;49(2):172-176, Mar.-Apr. 2016. tab.
Idioma: en.
Projeto: Tehran University of Medical Sciences and Health Services.
Resumo: Abstract INTRODUCTION: The aim of this study was to determine whether an herbal extract containing monoterpene exhibited activity against multidrug-resistant Staphylococcus aureus and Pseudomonas aeruginosa isolated from clinical infection samples. METHODS: The essential oil of Trachyspermum ammi (L.) Sprague ex Turrill (Apiaceae) fruit was extracted by hydrodistillation. Fruit residues were treated with hydrochloric acid and re-hydrodistilled to obtain volatile compounds. Compounds in the distilled oil were identified using gas-chromatography (GC) and GC-mass spectrometry (MS). The antibiotic susceptibility of all bacterial isolates was analyzed using both the disc diffusion method and determination of the minimum inhibitory concentration (MIC). The sensitivity of antibiotic-resistant isolates to essential oil was also determined by using the disc diffusion method and MIC determination. RESULTS: Of 26 clinical isolates, 92% were multidrug-resistant (MDR). Aromatic monoterpenes (thymol, paracymene, and gamma-terpinene) were the major (90%) components of the oil. Growth of S. aureus strains was successfully inhibited by the oil, with an inhibitory zone diameter (IZD) between 30-60mm and MIC <0.02μL/mL. The oil had no antimicrobial activity against clinical isolates of P. aeruginosa; rather, it prevented pigment production in these isolates. CONCLUSIONS: This study revealed that the essential oil of Trachyspermum ammi, which contains monoterpene, has good antibacterial potency. Monoterpenes could thus be incorporated into antimicrobial ointment formulas in order to treat highly drug-resistant S. aureus infections. Our findings also underscore the utility of research on natural products in order to combat bacterial multidrug resistance.
Descritores: Pseudomonas aeruginosa/efeitos dos fármacos
Staphylococcus aureus/efeitos dos fármacos
Apiaceae/química
Monoterpenos/farmacologia
Antifúngicos/farmacologia
-Óleos Vegetais/farmacologia
Óleos Voláteis/farmacologia
Testes de Sensibilidade Microbiana
Apiaceae/classificação
Farmacorresistência Bacteriana Múltipla
Monoterpenos/isolamento & purificação
Cromatografia Gasosa-Espectrometria de Massas
Antifúngicos/isolamento & purificação
Limites: Humanos
Responsável: BR1.1 - BIREME


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Id: biblio-1152242
Autor: Deglmann, Roseneide Campos; Oliveira, Débora de; França, Paulo Henrique Condeixa de.
Título: Perfil fenotípico de resistência à colistina e tigeciclina em um hospital público no Brasil / Phenotypical profile of colistin and tigecycline resistance in a public hospital in Brazil / Perfil fenotípico de resistencia a la colistina y tigeciclina en un hospital público de Brasil
Fonte: Rev. epidemiol. controle infecç;9(4):281-286, out.-dez. 2019. ilus.
Idioma: pt.
Resumo: Justificativa e objetivos: Infecções Relacionadas à Assistência à Saúde (IRAS) causadas por bacilos Gram negativos multirresistentes (BGN-MDR) são consideradas um problema de saúde pública e um impacto nas taxas de mortalidade nas Unidades de Terapia Intensiva (UTI). O objetivo deste estudo foi verificar o perfil fenotípico de resistência à colistina e à tigeciclina, consideradas como último recurso terapêutico aos BGN-MDR. Métodos: Os dados foram coletados nas fichas de busca ativa do serviço de controle de infecções e prontuários médicos de pacientes internados em duas UTIs de um hospital público de Joinville, entre janeiro de 2016 e junho de 2017. Resultados: Ocorreram 256 IRAS por BGN, acometendo principalmente o gênero masculino (62%), com mediana de idade de 65 anos. Entre os BGN, 37% expressaram MDR; sendo as espécies mais frequentes: Klebsiella pneumoniae e (47%), Acinetobacter baumannii (23%) e Stenotrophomonas maltophilia (11%). A resistência de BGN-MDR à colistina e tigeciclina foi de 5% e de 12%, respectivamente; 5% dos isolados foram resistentes aos dois antibióticos. A taxa de óbito entre os pacientes com IRAS por BGN-MDR resistentes à colistina foi mais alta (60%) que aquelas à tigeciclina (45%). Conclusão: K. pneumoniae e A. baumannii produtores de carbapenemases, resistentes a colistina e tigeciclina prevaleceram entre os BGN-MDR, e estiveram associadas a maioria dos óbitos. Essas observações, junto com o alto uso de carbapenêmicos na terapia empírica, mostra a necessidade do uso racional de antimicrobianos.(AU)

Background and objectives: Healthcare-associated Infections (HAIs) caused by multidrug-resistant Gram-negative bacilli (GNB-MDR) are considered a public health problem and have an impact on mortality rates in Intensive Care Units (ICU). The aim of this study was to verify the phenotypic profile of resistance to colistin and tigecycline, considered as the last antimicrobial choice to treat BGNMDR infections. Methods: Data were collected on the active search records of the infection control service and medical records of patients admitted to two ICUs at a public hospital in Joinville between January 2016 and June 2017. Results: There were 256 HAIs caused by GNB, mainly affecting males (62%), with a median age of 65 years. Among GNBs, 37% expressed MDR; the most frequent species were: Klebsiella pneumoniae (47%), Acinetobacter baumannii (23%) and Stenotrophomonas maltophilia (11%). The resistance of GNB-MDR to colistin and tigecycline was 5% and 12%, respectively; 5% of the isolates were resistant to both antibiotics. The death rate among patients with HAIs caused by colistin-resistant GNB-MDR was higher (60%) than those to tigecycline (45%). Conclusion: Carbapenemase-producing K. pneumoniae and A. baumannii, resistant to colistin and tigecycline, prevailed among GNB-MDRs, and were associated with most deaths. These observations, coupled with the high use of carbapenems in empirical therapy, show the need for rational use of antimicrobials.(AU)

Justificación y objetivos: Las Infección nosocomial (IHs) causadas por bacilos Gram negativos multirresistentes (BGN-MDR) se consideran un problema de salud pública y un impacto en las tasas de mortalidad en las Unidades de Terapia Intensiva (UTI). El objetivo de este estudio fue verificar el perfil fenotípico de resistencia a la colistina ya la tigeciclina, consideradas como último recurso terapéutico a los BGN-MDR. Métodos: Los datos fueron recolectados en las fichas de búsqueda activa del servicio de control de infecciones y prontuarios médicos de pacientes internados en dos UTIs de un hospital público de Joinville, entre enero de 2016 y junio de 2017. Resultados: Ocurrieron 256 IHs por BGN, que afectan principalmente al género masculino (62%), con mediana de edad de 65 años. Entre los BGN, el 37% expresó MDR; siendo las especies más frecuentes: Klebsiella pneumoniae (47%), Acinetobacter baumannii (23%) y Stenotrophomonas maltophilia (11%). La resistencia de BGN-MDR a la colistina y tigeciclina fue del 5% y del 12%, respectivamente; 5% de los aislados fueron resistentes a los dos antibióticos. La tasa de muerte entre los pacientes con IH causadas por los BGN-MDR resistentes la colistina fue más alta (60%) que aquellas a tigeciclina (45%). Conclusión: K. pneumoniae y A. baumannii productoras de carbapenemases, resistentes la colistina y la tigeciclina, fueron más frecuentes entre los BGN-MDR y su asociación estuvo presente en la mayoría de las muertes. Estas observaciones, junto con el alto uso de carbapenems en la terapia empírica, muestran la necesidad de un uso racional de los antimicrobianos.(AU)
Descritores: Colistina/farmacologia
Farmacorresistência Bacteriana Múltipla
Tigeciclina/farmacologia
Bactérias Gram-Negativas/efeitos dos fármacos
Antibacterianos/farmacologia
-Fenótipo
Infecção Hospitalar/tratamento farmacológico
Infecções por Bactérias Gram-Negativas/tratamento farmacológico
Colistina/uso terapêutico
Stenotrophomonas maltophilia/efeitos dos fármacos
Stenotrophomonas maltophilia/genética
Acinetobacter baumannii/efeitos dos fármacos
Acinetobacter baumannii/genética
Tigeciclina/uso terapêutico
Bactérias Gram-Negativas/genética
Hospitalização
Klebsiella pneumoniae/efeitos dos fármacos
Klebsiella pneumoniae/genética
Antibacterianos/uso terapêutico
Limites: Humanos
Masculino
Feminino
Adolescente
Adulto
Pessoa de Meia-Idade
Idoso
Adulto Jovem
Responsável: BR1314.1 - Biblioteca Central


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Id: lil-792801
Autor: Shahraki-Zahedani, Shahram; Rigi, Shahnaz; Bokaeian, Mohammad; Ansari-Moghaddam, Alireza; Moghadampour, Mehdi.
Título: First report of TEM-104-, SHV-99-, SHV-108-, and SHV-110-producing Klebsiella pneumoniae from Iran
Fonte: Rev. Soc. Bras. Med. Trop;49(4):441-445, July-Aug. 2016. tab, graf.
Idioma: en.
Resumo: Abstract: INTRODUCTION: Extended-spectrum beta-lactamases (ESBLs) are bacterial enzymes capable of hydrolyzing beta-lactams. The aim of this study was to describe the prevalence of TEM- and SHV-type ESBL-producing Klebsiella pneumoniae strains in Zahedan, Southeast Iran. METHODS: A total of 170 non-repetitive K. pneumoniae strains were collected from patients referred to three teaching hospitals of Zahedan. Antibiotic susceptibility testing was determined for 17 antibiotics using the Kirby-Bauer disc diffusion method. The frequency of ESBL-producing strains was calculated, and minimum inhibitory concentrations of ESBL-producing strains were determined for cefotaxime, ceftazidime, ceftriaxone, and cefpodoxime. The presence of bla TEM and bla SHV genes was tested in all ESBL-producing strains using polymerase chain reaction and DNA sequencing. RESULTS: Among the 170 K. pneumoniae clinical isolates, 55 (32.4%) were ESBL producers; 92.7% (n=51) and 72.7% (n=40) of the isolates carried the bla SHV and bla TEM genes, respectively, and 67.3% (n=37) carried both genes. The sequencing results showed that all bla TEM types were bla TEM-1, except for two isolates that were bla TEM-104. The bla SHV types were bla SHV-1, bla SHV-11, bla SHV-12, bla SHV-99, bla SHV-108, and bla SHV-110. CONCLUSIONS: The percentage of bla TEM and bla SHV among ESBL-producing K. pneumoniae isolates from Zahedan is relatively high, indicating the need for further surveillance and consideration in antibiotic use. To the best of our knowledge, this is the first report of TEM-104-, SHV-99-, SHV-108-, and SHV-110-type ESBLs among clinical isolates of K. pneumoniae from Iran, and TEM-1, SHV-1, SHV-11, and SHV-12 appear to be the dominant ESBLs in this region.
Descritores: Proteínas de Bactérias/genética
beta-Lactamases/biossíntese
DNA Bacteriano/genética
Klebsiella pneumoniae/efeitos dos fármacos
Klebsiella pneumoniae/genética
Antibacterianos/farmacologia
-Fenótipo
Infecções por Klebsiella/microbiologia
Análise de Sequência de DNA
Farmacorresistência Bacteriana Múltipla/genética
Testes de Sensibilidade a Antimicrobianos por Disco-Difusão
Genes Bacterianos
Genótipo
Irã (Geográfico)
Limites: Humanos
Responsável: BR1.1 - BIREME



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