RESUMEN
INTRODUCTION: COVID-19 is a viral infection that disturbs the host's immune system and causes an overproduction of cytokines leading to a cytokine storm. The present study aimed to evaluate the serum levels of 27 protein biomarkers to determine their association with COVID-19 disease severity. METHODS: The serum levels of 89 patients with different degrees of COVID-19 disease severity [asymptomatic (n = 14), moderate (n = 14), severe (n = 30), and critical (n = 31)] and 14 healthy individuals were tested for a panel of 27 cytokines and chemokines using Luminex assay (27 BioPlex Pro Human Cytokine, Bio-rad™). RESULTS: IL-12, IL-2 and IL-13, as well as IL-17 and GM-CSF were clearly undetectable in asymptomatic patients. IL-8 levels were higher in asymptomatic compared with other groups. Very high levels of IL-6, IL-10 and the chemokines MIP-1α, MCP-1 and IP10 were associated with disease progression, while IL-4 tends to decrease with disease severity. CONCLUSION: Our study provides more evidence that excessive cytokine synthesis is linked to the disease progression.
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COVID-19 , Quimiocinas , Citocinas , SARS-CoV-2 , Índice de Severidad de la Enfermedad , Humanos , COVID-19/sangre , COVID-19/inmunología , Masculino , Femenino , Citocinas/sangre , Persona de Mediana Edad , Quimiocinas/sangre , Adulto , Biomarcadores/sangre , Anciano , Progresión de la EnfermedadRESUMEN
BACKGROUND: Intensive care units (ICUs) are considered epicenters of antibiotic resistance. The aim of this study is to determine clinical risk factors, epidemiology and the causative agents of multi-drug resistant bacteria in the ICU of the University Hospital in Marrakesh-Morocco. METHODS: A one year case control study was carried out in our 10-bed clinical and surgical ICU from March 2015 to March 2016. The epidemiological surveillance was done by collecting data in the medical records with the help of a questionnaire. The antibiotic susceptibility testing was used following the recommendations of the Antibiogram Committee of the French Society of Microbiology and the European Committee for Antimicrobial Susceptibility Testing, 2015. RESULTS: Among the 479 admitted patients, 305 bacteria were isolated and identified as Acinetobacter baumannii (31%), Enterobactereacae species (30%), and Staphylococcus (24%), P. aeruginosa (10%) and other bacterial strains (5%). The rate of MDR bacteria acquisition was 41% (124/305) with domination of A. baumannii resistant to imipenem (70%) and followed by Extended Spectrum ß-lactamases producing Enterobacteriaceae, P. aeruginosa resistant to Ceftazidime, and Methicillin-resistant S. aureus (18%, 7%, and 5% respectively). The distribution of the common nosocomial infections were dominated by pneumonia, bacteremia, and catheter-related blood stream infections (39%, 29%, and 17%) respectively. Multivariate analysis identified lack of patient isolation precautions (OR: 7.500), use of quadri or triple therapy (OR: 5.596; OR: 5.175), and mechanical ventilation (OR: 4.926), as the most significant clinical and epidemiological factors associated with acquisition of MDR bacteria. The attributable mortality, in this ICU, of patients with MDR bacteria, is about 12%. CONCLUSIONS: The incidence of MDR was higher compared with that of developed countries. The implementation of standard infection control protocols, active surveillance of MDR and generation of data on etiological agents and their antimicrobial susceptibility patterns are urgently needed in our hospital.
Asunto(s)
Infección Hospitalaria/etiología , Unidades de Cuidados Intensivos , Infecciones por Acinetobacter/epidemiología , Infecciones por Acinetobacter/etiología , Infecciones por Acinetobacter/microbiología , Acinetobacter baumannii/efectos de los fármacos , Adulto , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Estudios de Casos y Controles , Infección Hospitalaria/epidemiología , Infección Hospitalaria/microbiología , Farmacorresistencia Bacteriana Múltiple , Enterobacteriaceae/efectos de los fármacos , Infecciones por Enterobacteriaceae/tratamiento farmacológico , Femenino , Hospitales Universitarios , Humanos , Masculino , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Marruecos/epidemiología , Infecciones por Pseudomonas/tratamiento farmacológico , Infecciones por Pseudomonas/epidemiología , Infecciones por Pseudomonas/microbiología , Factores de Riesgo , Infecciones Estafilocócicas/tratamiento farmacológico , Staphylococcus/efectos de los fármacos , Adulto JovenRESUMEN
Monitoring of Streptococcus pneumoniae antibiotic resistance is of great importance due to the frequency of strains becoming increasingly resistant to antibiotics. In this study, we report the antibiotic susceptibility of the serotypes of S. pneumoniae strains isolated from healthy children aged 1-24 months in the Marrakech region of Morocco. Resistance to penicillin (38.7%) was frequently associated with resistance to other antibiotics. The highest rates of resistance were to cotrimoxazole (trimethoprim/sulfamethoxazole) (49.3%), erythromycin (48.7%), tetracycline (37.3%), lincomycin (35.3%), chloramphenicol (32.7%) and ciprofloxacin (24%). Prisitinamycin and vancomycin were effective against all isolated pneumococcal strains (100% sensitive strains). Gentamycin demonstrated good efficacy on S. pneumoniae, with 98.7% of strains being sensitive. Multidrug resistance characterized 43.33% of all studied strains. Of the multidrug-resistant strains, 36.92% were resistant to erythromycin (E), tetracycline (T) and cotrimoxazole (Co: sulfamethoxazole-trimethoprim) (phenotype ETCo, n = 24), and 20% had decreased susceptibility to beta-lactams, erythromycin and cotrimoxazole (phenotype PECo, n = 13). A total of 29.23% of S. pneumoniae strains exhibited combined resistance to four antibiotics (phenotype PETCo, n = 19). This study reports the status of resistance and multiresistance of S. pneumoniae strains in the Marrakech region of Morocco.