RESUMO
Beta-lactamase-producing (Bla+) enterococci have been reported in three state and two countries. Pulsed-field gel electrophoresis was used to compare 14 Bla+ Enterococcus (Streptococcus) faecalis isolated from hospitalized patients in seven states and three continents. The restriction endonuclease digestion patterns of isolates from Connecticut, Massachusetts, Lebanon, and Argentina were all markedly different, indicating that these were different strains. However, isolates from Delaware, Texas, Pennsylvania (Philadelphia and Pittsburgh), Florida, and Virginia were similar, indicating that these isolates were derivatives of a single strain. This conclusion was supported by hybridization using individual fragments as probes. Spread of Bla+ enterococci within the hospital setting was also demonstrated. These findings illustrate the value of pulsed-field gel electrophoresis for epidemiologic analyses and support the importance of identifying and containing organisms with new resistance properties in an effort to decrease their transmission to and from, as well as within, hospitals.
Assuntos
DNA Bacteriano/análise , Enterococcus faecalis/classificação , Infecções Estreptocócicas/microbiologia , beta-Lactamases/biossíntese , Argentina , Boston , Connecticut , Delaware , Eletroforese em Gel de Ágar , Enterococcus faecalis/enzimologia , Enterococcus faecalis/genética , Florida , Humanos , Líbano , Hibridização de Ácido Nucleico , Pennsylvania , Philadelphia , Plasmídeos , Mapeamento por Restrição , Infecções Estreptocócicas/transmissão , Texas , VirginiaRESUMO
En este trabajo se revisa la bacteriología y patogenesis de las infecciones del pie en el diabético y se intenta assiliar a una comprensión socio-real de las opciones que presenta la antibióticoterapia. Se concluye que para obtener resultados óptmos en el tratamiento de estas ionfeciones se requiere un enfoque clinicoquirurgico combinado con el uso emféccio de antibióticos en forma temprana
Assuntos
Adulto , Humanos , Masculino , Feminino , Antibacterianos/uso terapêutico , Infecções Bacterianas/terapia , Diabetes Mellitus/complicações , Pé/patologiaRESUMO
En este trabajo se revisa la bacteriología y patogenesis de las infecciones del pie en el diabético y se intenta assiliar a una comprensión socio-real de las opciones que presenta la antibióticoterapia. Se concluye que para obtener resultados óptmos en el tratamiento de estas ionfeciones se requiere un enfoque clinicoquirurgico combinado con el uso emféccio de antibióticos en forma temprana (AU)
Assuntos
Adulto , Humanos , Masculino , Feminino , Antibacterianos/uso terapêutico , Infecções Bacterianas/terapia , Pé/patologia , Diabetes Mellitus/complicaçõesRESUMO
From Jan 1, 1981 to Oct 31, 1984, 24 of 280 (8.6 percent) patients with acquired immunodeficiency syndrome (AIDS) had tuberculosis. No patient with both AIDS and tuberculosis was Haitian. In 15 patients, tuberculosis was diagnosed prior to or concomitant with the diagnosis of AIDS. Twelve patients (50 percent) had Mycobacterium tuberculosis grown from at least one extrapulmonary site. Although the clinical presentation was variable, no patient had cavitary and only one had apical disease. Histologic examination of lung and transbronchial biopsy specimens usually did not reveal acid-fast bacilli or granulomas. Seventeen patients were treated and all showed clinical improvement. Tuberculosis was infrequent but not rare in our patients and often preceded the diagnosis of AIDS. Despite the fact that many of these patients had both severe and extrapulmonary disease, they appeared to respond well to treatment.