RESUMEN
The phenotypic and genotypic characterization of five clinical isolates of Leuconostoc pseudomesenteroides associated with nosocomially acquired urinary tract infections is described. All the strains were susceptible to chloramphenicol, clindamycin, erythromycin, gentamicin, and tetracycline; all were resistant to nalidixic acid, norfloxacin, and vancomycin; and all were intermediately affected by ampicillin and penicillin. Analysis of chromosomal DNA by pulsed-field gel electrophoresis after treatment with SmaI indicated a clonal relationship of the isolates. The results provide evidence for the possibility of nosocomial transmission of this unusual opportunistic, vancomycin-resistant pathogen.
Asunto(s)
Infección Hospitalaria/microbiología , Infecciones por Bacterias Grampositivas/microbiología , Leuconostoc/clasificación , Infecciones Urinarias/microbiología , Adolescente , Adulto , Técnicas de Tipificación Bacteriana , Infección Hospitalaria/transmisión , Electroforesis en Gel de Campo Pulsado , Electroforesis en Gel de Poliacrilamida , Femenino , Infecciones por Bacterias Grampositivas/transmisión , Humanos , Leuconostoc/efectos de los fármacos , Leuconostoc/genética , Leuconostoc/aislamiento & purificación , Masculino , Pruebas de Sensibilidad Microbiana , Infecciones Urinarias/transmisiónRESUMEN
Two Corynebacterium diphtheriae strains were analyzed by assays employing a battery of highly purified fluorescent lectins. From 22 lectins tested only seven with affinity to receptor molecules containing N-acetylglucosamine (D-GlcNAc), N-acetylgalactosamine (D-GalNAc), galactose (D-Gal), mannose-like (D-Man-like) and sialic acid residues showed positive fluorescent labeling. A higher reactivity of Triticum vulgaris (WGA), which binds to sialic acid and/or beta-D-GlcNAc-containing residues, and Bandeiraea simplicifolia II (BS-II), which recognizes alpha and beta-D-GlcNAc units, was shown by the sucrose-fermenting strain. Ricinus communis (RCA-I), which recognizes D-Gal units in addition to both Glycine max (SBA) and Artocarpus integrifolia (Jacaline) agglutinins that bind to D-GalNAc-containing residues, reacted preferentially with the sucrose-negative strain. Canavalia ensiformis (Con A), which recognizes D-Man-like receptors, reacted with both sucrose-fermenting and non-sucrose-fermenting C. diphtheriae biotypes. However, higher interaction was observed with the non-sucrose-fermenting strain. Fluorescence of WGA binding was significantly decreased by neuraminidase treatment suggesting the presence of an exposed sialic acid moiety on C. diphtheriae surfaces. Binding assay using radiolabeled [125I]WGA essentially confirmed the lectin fluorescence studies. N-Acetylneuraminic acid moieties were detected in whole cell hydrolysates as assessed by thin-layer and gas-liquid chromatography. The data indicate differences on the cell surface saccharide ligands between the sucrose-fermenting and the non-sucrose-fermenting C. diphtheriae strains.
Asunto(s)
Corynebacterium diphtheriae/química , Corynebacterium diphtheriae/clasificación , Polisacáridos Bacterianos/química , Polisacáridos Bacterianos/metabolismo , Cromatografía de Gases , Cromatografía en Capa Delgada , Corynebacterium diphtheriae/metabolismo , Difteria/microbiología , Fluorescencia , Humanos , Isotiocianatos/metabolismo , Lectinas/metabolismo , Ácido N-Acetilneuramínico/metabolismo , Aglutininas del Germen de Trigo/metabolismoRESUMEN
UNLABELLED: Postoperative pain control after cesarean delivery under spinal anesthesia is effectively obtained with morphine 0.1-0.3 mg intrathecally, although there may be dose-dependent side effects. We evaluated the quality of analgesia and the incidence of side effects with smaller doses of intrathecal morphine combined with intramuscular (i.m.) diclofenac. One hundred-twenty pregnant patients were allocated into six groups, which received the following treatments: Groups 1, 3, and 5 received 0.1, 0.05, and 0.025 mg of intrathecal morphine, respectively, plus 75 mg of i.m. diclofenac every 8 h; Groups 2, 4, and 6 received 0.1, 0.05, and 0.025 mg of intrathecal morphine, respectively, plus i.m. diclofenac on demand. Spinal anesthesia was performed with 15 mg of 0.5% hyperbaric bupivacaine. Pain scores and side effects were evaluated hourly for the first 24 h. Groups 1 and 2 had lower pain scores than Groups 3, 4, 5, and 6. However, only patients in Groups 2, 4, and 6 requested additional analgesics. Severe pruritus was more frequent in Groups 1 and 2. No patient experienced respiratory depression. We conclude that there is no advantage in using doses larger than 0.025 mg of intrathecal morphine if they are combined with systemic diclofenac. IMPLICATIONS: A multimodal approach to pain control may provide good quality analgesia while reducing drug-related side effects. In this study, a very small dose of intrathecal morphine, in association with intramuscular diclofenac, proved effective for controlling pain after cesarean delivery, with a low incidence of morphine-induced pruritus.