RESUMO
Forty infection-associated VanA-type vancomycin-resistant Enterococcus faecium (VRE) strains obtained from five collaborating hospitals in Asunción, Paraguay were investigated. Genotyping using pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing revealed the presence of 17 cluster types and four STs, with 93% (37/40) of isolates comprising ST type 78. Other ST types included ST-132, ST-210 and one new ST type (ST-438). All but one isolate (ST-438) were associated with clonal complex 17 (CC17), and 97% of the total isolates carried the esp gene. Three Tn1546 variants were found, including a new lineage containing an ISEfa5 insertion in an existing IS1251 element.
Assuntos
Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Enterococcus faecium/efeitos dos fármacos , Infecções por Bactérias Gram-Positivas/epidemiologia , Infecções por Bactérias Gram-Positivas/microbiologia , Resistência a Vancomicina , Proteínas de Bactérias/genética , Técnicas de Tipagem Bacteriana , Carbono-Oxigênio Ligases/genética , Análise por Conglomerados , Impressões Digitais de DNA , Elementos de DNA Transponíveis , DNA Bacteriano/genética , Eletroforese em Gel de Campo Pulsado , Enterococcus faecium/isolamento & purificação , Genótipo , Hospitais , Humanos , Paraguai/epidemiologia , Prevalência , Análise de Sequência de DNARESUMO
El propósito de la presente comunicación es resaltar una forma más de presentación de la lepra lepromatosa, en la cual la clínica y los métodos laboratoriales fueron determinantes para el diagnóstico correcto y mejoría clínica. Si bien la lepra se presenta en distintas formas a través de un aspecto muy amplio, nos pareció oportuno revelar el hallazgo de un paciente varón con algunas lesiones ulcerocostrosas de aspecto ectimatoso, crónicas. Pérdida de sensibilidad e importante disminución de peso.
Assuntos
Hanseníase , Hanseníase Virchowiana/classificação , Hanseníase Virchowiana/diagnósticoRESUMO
Several in vitro techniques have been developed, which are able to quantify the bactericidal activity of a determined antibacterial drug against an infective agent. The Serum Bactericidal Rate (SBR) is proposed as a complementary technique for the determination of the "killing curve", the serum bactericidal test or the minimal bactericidal concentration. SBR takes into account the most advantageous features of both of them. SBR is based on quantifying at different times the survival of the bacterial inoculum exposed to the patient's serum. Thus, bactericide speed is evaluated in the first hours of contact with the microorganism (as in the "killing curve"), but taking into account drug concentrations which have been reached by the patient (as in the serum bactericidal test). Preliminary assays suggest that SBR may have greater capacity to discriminate an infectious agent in answer to different therapeutic schemes than other determinations, although prospective studies are required to evaluate its predictive value.
Assuntos
Quimioterapia Combinada/uso terapêutico , Penicilinas/uso terapêutico , Teste Bactericida do Soro , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus bovis , Estreptomicina/uso terapêutico , Quimioterapia Combinada/administração & dosagem , Feminino , Humanos , Penicilinas/administração & dosagem , Estreptomicina/administração & dosagem , Fatores de TempoAssuntos
Bactérias/isolamento & purificação , Bile/microbiologia , Adolescente , Adulto , Idoso , Doenças Biliares/fisiopatologia , Criança , Pré-Escolar , Colangite/fisiopatologia , Colestase/fisiopatologia , Enterobacteriaceae/isolamento & purificação , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Bactérias , Bile , PunçõesRESUMO
In 78 children with idiopathic nephrotic syndrome, the levels of serum immunoglobulins were studied. In 45 cases with lipoid nephrosis, 7 with segmentary and focal sclerosis and in 26 with membranoproliferative glomerulonephritis, a reduction in per centum values of IgG were found in similar magnitude in the groups. Levels for IgA were not found abnormal and there was an increase in values for IgM exclusively in cases of lipoid nephrosis. There was no difference between disorders shown by cases of active lipoid nephrosis at the beginning or following relapse after some time of evolution. On the other hand it was found that disorders that appeared significantly in magnitude in cases undergoing remission, but specially in those with a greater time of evolution. The difference in these findings with those reported by other authors are attributed to multifactorial causes of lipoid nephrosis and it is supposed that disorders of immunoglobulins represent a functional defect of the lymphocytes T similar to that described as "immunodeficiency linked to chromosome X with high IgM". The association of lipoid nephrosis with certain types of locus HL-A suggest that these immunity alterations might signify a predisposing factor genetically transmitted and suggest the systematic study of these abnormalities in parents and siblings of patients with this disease.
Assuntos
Imunoglobulinas/análise , Síndrome Nefrótica/imunologia , Adolescente , Adulto , Fatores Etários , Criança , Pré-Escolar , Feminino , Humanos , Imunoglobulina G/análise , Imunoglobulina M/análise , Lactente , Masculino , Síndrome Nefrótica/genéticaAssuntos
Glomerulonefrite/complicações , Refluxo Vesicoureteral/complicações , Injúria Renal Aguda/etiologia , Injúria Renal Aguda/cirurgia , Criança , Complemento C3/análise , Feminino , Glomerulonefrite/imunologia , Humanos , Imunoglobulina A/análise , Imunoglobulina G/análise , Transplante de Rim , NefrectomiaRESUMO
Endogenous creatinine clearance was studied in thirty children with various renal diseases and variable degrees of functional deterioration. Two different procedures or urine collection were used on each child: 1) twenty-four-hour urine collection with one blood sample and immediately afterwards 2) three one-hour consecutive periods of urine collection, with one previous blood sample (the one used for the 24-hour procedure). Both procedures were carried out during hydration of the patient and creatinine was determined with the autoanalyzer in urine and blood samples. The results obtained with both procedures did not show significant difference. The three-hour periods procedure may be recommended for hospitalized patients, specially infants or young children, and also when the parents are not reliable enough for hydrating the patients and for performing a complete collection of urine in a 24 hour period.