RESUMO
OBJECTIVES: Carbapenem-resistant Gram-negative bacilli (CRGNB) have been reported in different wastewater treatment plants (WWTPs) throughout the world; however, few studies have described the antimicrobial resistance profile in different CRGNB throughout WWTPs, information that would identify points of selection of resistant bacteria. The objective of this work was to characterize the resistance profile of CRGNB harbouring blaKPC-2 from a Colombian WWTP. METHODS: Six samples were taken from four points of a WWTP. CRGNB were selected in chromID® CARBA and identified by 16S rRNA. Carbapenemases were determined by polymerase chain reaction (PCR), and susceptibility was assessed using VITEK2. RESULTS: One hundred and forty-two CRGNB harbouring blaKPC-2 were detected: 41% corresponded to Aeromonas spp. (n = 58) and 59% to Enterobacteriaceae. To establish the resistance profile, 50% of the isolates were selected proportionally by family and sampling point (26 Aeromonadaceae and 45 Enterobacteriaceae). All Enterobacteriaceae showed resistance to carbapenems and penicillins + inhibitors, high percentages of resistance to ceftriaxone (88.9%), and ciprofloxacin (44.4%), and low resistance to other antibiotics (>30%). In Aeromonadaceae, 76.9% were resistant to ceftriaxone, 58% to carbapenems, and 65.4% to ciprofloxacin. Twenty-one resistance profiles were observed, the most common of which were resistant to penicillins + inhibitor, cephalosporins (third to fourth generation), and carbapenems (19%). The percentage of multidrug resistance was 91% and was similar at all points of the WWTP. CONCLUSIONS: The high frequency of multidrug resistance and great diversity of resistance profiles observed throughout the WWTP is of concern, and shows the role of WWTP as a reservoir and dissemination source of antimicrobial resistance to water sources.
Assuntos
Carbapenêmicos , Purificação da Água , Carbapenêmicos/farmacologia , Colômbia , Resistência a Múltiplos Medicamentos , RNA Ribossômico 16S/genéticaRESUMO
INTRODUCTION: Anaplastic large-cell lymphoma (ALCL) is an infrequent childhood malignancy whose diagnosis and treatment have largely evolved since its initial description in 1985. PATIENTS AND METHODS: We retrospectively reviewed our experience in the field, and report here a single institution experience focusing on diagnostic and therapeutic milestones achieved as novel tools have been developed. This is a series of 9 children diagnosed from 1987 to 2007. RESULTS: Our first patient was diagnosed shortly alter this entity was described based on morphology and Ki-1 positivity, while the diagnostic work-up for the last two children included accurate molecular diagnosis for ALK-NPM rearrangement. Despite a wide variety of multimodal therapies used over time, only one patient died of toxicity during progression and another child relapsed and survived alter an autograft. After 156 months of median follow-up (range 4-245), 8 out of 9 children are alive, free of disease. CONCLUSIONS: Our series exemplifies the long journey travelled from the definition of a new entity only 20 years ago to the molecular characterization not only with diagnostic but also therapeutic purposes. Besides this, significant efforts are being made to recruit all European patients into a multinational collaborative trial in order to start drawing major evidence-based conclusions.
Assuntos
Linfoma Anaplásico de Células Grandes/diagnóstico , Linfoma Anaplásico de Células Grandes/tratamento farmacológico , Adolescente , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Criança , Pré-Escolar , Feminino , Humanos , Linfoma Anaplásico de Células Grandes/mortalidade , Masculino , Estudos Retrospectivos , Resultado do TratamentoRESUMO
PIP: The Atlantic region contains 20% of Colombia's population, including 1.4 million women aged 15-49. 2/3 of the population is urban. Despite an increase in contraceptive usage from 39% in 1978 to 52% in 1986, the region still has the lowest prevalence of any of Colombia's major regions. PROFAMILIA has planned campaigns to increase contraceptive usage in the Atlantic region and to encourage the use of temporary methods for birth spacing. The 1st survey of the Atlantic Coast was conducted in 1988 to obtain information on contraceptive use and attitudes as the basis for a campaign to promote use of Microgynon 21 oral contraceptives (OCs) and Tahiti condoms. 59% of women in union were using a method at the time of the survey. In urban and rural areas respectively, 17.9% and 12.2% used pills, 25.8% and 23.8% used female sterilization, 4.9% and 2.8% used IUDs, and 2.5% and 2.8% used injectables. Only .9% and 1.1% used vaginal methods, and .6% and .2% used condoms. No men in rural areas and .2% in urban areas chose vasectomy. 91% of OC users reported taking a pill each day, but some users took one only when they had sexual relations or 1 each week. 70% of users waited an incorrect number of days before starting a new cycle. Over half responded correctly that if they forgot a pill they should take another immediately and follow the regular cycle. Over half of current pill users had thought of changing methods, with over half of those considering sterilization, 28% the IUD, and 12% injectables. 38% of OC users thinking of changing methods would do so because of side effects and 36% because they were tired of taking a pill each day. All users of vaginal methods reported using them correctly. Condoms are usually purchased by men, who prefer to buy them at the drug store. All urban condom users reported having considered changing methods, 3/4 to female sterilization and 1.4 to an IUD. 65% of sterilized women reported undergoing the operation because they wanted no more children, 28% on the recommendation of a physician, and 4% because of economic problems. Over 95% of sterilized women reported satisfaction with the operation.^ieng
Assuntos
Comportamento Contraceptivo , Anticoncepção , Serviços de Planejamento Familiar , Conhecimento , População Rural , População Urbana , América , Colômbia , Demografia , Países em Desenvolvimento , América Latina , População , Características da População , América do SulRESUMO
Teniendo un cuenta que la seleccion de auxiliares de enfermeria en los hospitales locales de la Regional de Girardot es una actividad de la enfermera durante el ano de servicio social obligatorio se hizo este manual con el proposito de suministrar parametros objetivos para la realizacion de esta importante tarea administrativa. Para tal efecto se describen los principios de la seleccion del personal: a) colocacion (identificacion de las cualidades del candidato para desempenar un rol) b) orientacion (asesoria personal u ocupacional a las personas (rechazadas) c) etica (responsabilidad en la toma de desiciones del aceptar o rechazar un candidato. Las tecnicas de seleccin del candidato: vacantes, solicitud, fuentes de reclutamiento, entrevista, pruebas de trabajo y requisitos laborales.