RESUMEN
A urinary tract infection (UTI) in humans is one of the most common ailments in developing countries. The treatment of UTI is becoming difficult because of the increasing drug resistance against the common bacteria associated with UTI. This research aimed to determine the bacteria, and their antimicrobial drug resistance, associated with UTI in the Grenada population. A retrospective study of data (2015 through 2017) from the microbiology laboratory of the Grenada General Hospital was analyzed. Bacteria were isolated from 1289 (33.3%) urine cultures of 3867 UTI suspected urine samples. Both Gram-positive (Staphylococcus aureus 5.0%; Enterococci group D 43.2%) and Gram-negative bacteria (Escherichia coli 51%; Klebsiella pneumoniae20.0%; Proteus mirabilis 10.0%; Acinetobacter spp. 20.0%) were isolated. Bacterial isolates were tested for their resistance to nine antibacterial drugs (ampicillin, gentamicin, norfloxacin, cefuroxime, ceftazidime, Bactrim, imipenem, augmentin, and ciprofloxacin). Gram-negative bacteria showed higher antimicrobial drug resistance.
RESUMEN
BACKGROUND: Development of donor-specific antibodies (DSA) after lung transplantation is associated with antibody mediated rejection, acute cellular rejection, and bronchiolitis obliterans syndrome; however, the significance of circulating antibodies before transplant remains unclear. METHODS: We performed a retrospective cohort study including recipients of primary lung transplants between 2008 and 2012. We assessed the impact of circulating HLA and noncytotoxic DSA detected before transplant on development of Chronic Lung Allograft Dysfunction (CLAD) or CLAD-related death. RESULTS: 30% of subjects had circulating class I antibodies alone, 4% Class II, and 14.4% class I and class II at mean fluorescent intensity greater than 1000. Nine percent of the subjects had DSA class I, 9% class II, and 2.4% both DSA classes 1 and 2. Neither the presence of circulating antibodies (adjusted hazard ratio, 0.87; 95% confidence interval, 0.50-1.54) nor the presence of DSA (adjusted hazard ratio, 1.56; 95% confidence interval, 0.77-3.18) before transplant at mean fluorescent intensity greater than 1000 was associated with the development of CLAD or CLAD-related death. CONCLUSIONS: Although in previous studies we have shown an increased incidence of antibody-mediated rejection in patients with pretransplant DSA, neither the presence of HLA antibodies nor DSA translated to an increased risk of allograft dysfunction or death if prospective crossmatch testing was negative. Prospective studies are needed to define the impact of pretransplant sensitization on lung transplant recipients.