RESUMO
Introduction: The appearance of multidrug-resistant and beta-lactamase producing enterobacteria in outpatient care facilities represent a public health problem in Perú. Objective: To compare the resistance profiles of uropathogenic Escherichia coli and to identify extended-spectrum beta-lactamase-producing phenotypes in three private health facilities located in the Peruvian coast, Andean and jungle regions. Materials and methods: We conducted a descriptive study on 98 urine samples from Lima (coast), Juliaca (Andean region) and Iquitos (jungle region) during 2016. We determined the antimicrobial susceptibility in 35 samples from Lima, 38 from Juliaca and 25 from Iquitos using eight antibiotic disks in samples from patients diagnosed with urinary infection. We also evaluated the production of extended-spectrum beta-lactamases with cefotaxime and ceftazidime disks and a combination of both with clavulanic acid on Mueller-Hinton agar. Results: We identified 18 resistance profiles ranging from those sensitive to others simultaneously resistant to seven antibiotics: 18.4% resistant to one and 54.0% to multiple antibiotics. We detected beta-lactamase production in 28.6% of the strains from the Puno region. Likewise, we observed a greater number of cases with resistance to ceftazidime, ceftriaxone, gentamicin, and trimethoprim-sulfamethoxazole in Puno's health facility in patients within the 31 to 45 year age range. Conclusion: Resistance profiles varied according to the geographical location of the health facilities under study. Resistance to antibiotics was higher in the Andean region with 28.6% of strains producing extended-spectrum beta-lactamases.
Introducción. La aparición de enterobacterias multirresistentes y productoras de betalactamasas de espectro extendido en pacientes ambulatorios con infecciones urinarias representa un problema de salud pública en Perú. Objetivo. Comparar los perfiles de resistencia de Escherichia coli uropatógenas e identificar los fenotipos de cepas productoras de betalactamasas de espectro extendido en tres establecimientos privados de salud localizados en las regiones de la costa, la sierra y la selva de Perú. Materiales y métodos. Se llevó a cabo durante el 2016 un estudio descriptivo de 98 muestras de orina de pacientes con infección urinaria, 35 procedentes de Lima (costa), 38 de Juliaca (sierra) y 25 de Iquitos (selva), en el que se determinó la sensibilidad antimicrobiana utilizando ocho discos antibióticos. Asimismo, se evaluó la producción de betalactamasas de espectro extendido con discos de cefotaxima, de ceftazidima o de su combinación, con ácido clavulánico en agar Mueller-Hinton. Resultados. Se identificaron 18 perfiles de resistencia que incluían desde los sensibles a todos los antibióticos hasta los resistentes simultáneamente a siete antibióticos, con el 18,4 % de aislamientos resistentes a un antibiótico y el 54,0 % de multirresistentes. Se detectó producción de betalactamasas en el 28,6 % de las cepas procedentes de la región de Puno. También, se observó un mayor número de casos en el rango de edad de 31 a 45 años con resistencia a ceftazidima, ceftriaxona, gentamicina y trimetoprim-sulfametoxazol en el establecimiento de salud de Puno. Conclusión. Los perfiles de resistencia variaron según la localización geográfica del establecimiento de salud.
Assuntos
Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Escherichia coli/efeitos dos fármacos , Escherichia coli/enzimologia , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/microbiologia , beta-Lactamases/biossíntese , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Farmacorresistência Bacteriana , Escherichia coli/genética , Instalações de Saúde , Humanos , Lactente , Pessoa de Meia-Idade , Peru , Fenótipo , Instalações Privadas , Adulto JovemRESUMO
Introducción. La aparición de enterobacterias multirresistentes y productoras de betalactamasas de espectro extendido en pacientes ambulatorios con infecciones urinarias representa un problema de salud pública en Perú. Objetivo. Comparar los perfiles de resistencia de Escherichia coli uropatógenas e identificar los fenotipos de cepas productoras de betalactamasas de espectro extendido en tres establecimientos privados de salud localizados en las regiones de la costa, la sierra y la selva de Perú. Materiales y métodos. Se llevó a cabo durante el 2016 un estudio descriptivo de 98 muestras de orina de pacientes con infección urinaria, 35 procedentes de Lima (costa), 38 de Juliaca (sierra) y 25 de Iquitos (selva), en el que se determinó la sensibilidad antimicrobiana utilizando ocho discos antibióticos. Asimismo, se evaluó la producción de betalactamasas de espectro extendido con discos de cefotaxima, de ceftazidima o de su combinación, con ácido clavulánico en agar Mueller-Hinton. Resultados. Se identificaron 18 perfiles de resistencia que incluían desde los sensibles a todos los antibióticos hasta los resistentes simultáneamente a siete antibióticos, con el 18,4 % de aislamientos resistentes a un antibiótico y el 54,0 % de multirresistentes. Se detectó producción de betalactamasas en el 28,6 % de las cepas procedentes de la región de Puno. También, se observó un mayor número de casos en el rango de edad de 31 a 45 años con resistencia a ceftazidima, ceftriaxona, gentamicina y trimetoprim-sulfametoxazol en el establecimiento de salud de Puno. Conclusión. Los perfiles de resistencia variaron según la localización geográfica del establecimiento de salud, observándose mayor resistencia a los antibióticos en la región de la sierra de Perú, con el 28,6 % de cepas productoras de betalactamasas de espectro extendido.
Introduction: The appearance of multidrug-resistant and beta-lactamase producing enterobacteria in outpatient care facilities represent a public health problem in Perú. Objective: To compare the resistance profiles of uropathogenic Escherichia coli and to identify extended-spectrum beta-lactamase-producing phenotypes in three private health facilities located in the Peruvian coast, Andean and jungle regions. Materials and methods: We conducted a descriptive study on 98 urine samples from Lima (coast), Juliaca (Andean region) and Iquitos (jungle region) during 2016. We determined the antimicrobial susceptibility in 35 samples from Lima, 38 from Juliaca and 25 from Iquitos using eight antibiotic disks in samples from patients diagnosed with urinary infection. We also evaluated the production of extended-spectrum beta-lactamases with cefotaxime and ceftazidime disks and a combination of both with clavulanic acid on Mueller-Hinton agar. Results: We identified 18 resistance profiles ranging from those sensitive to others simultaneously resistant to seven antibiotics: 18.4% resistant to one and 54.0% to multiple antibiotics. We detected beta-lactamase production in 28.6% of the strains from the Puno region. Likewise, we observed a greater number of cases with resistance to ceftazidime, ceftriaxone, gentamicin, and trimethoprim-sulfamethoxazole in Puno's health facility in patients within the 31 to 45 year age range. Conclusion: Resistance profiles varied according to the geographical location of the health facilities under study. Resistance to antibiotics was higher in the Andean region with 28.6% of strains producing extended-spectrum beta-lactamases.
Assuntos
Infecções Urinárias , Resistência a Medicamentos , Enterobacteriaceae , Peru , beta-Lactamases , Testes de Sensibilidade a Antimicrobianos por Disco-DifusãoRESUMO
Objectives: To describe acute toxicity, antibacterial activity and phytochemical assessment of Chlorella vulgaris and Spirulina platensis powders. Material and Methods: FeCl3 test, Wagner test, Keller Killiani test, frothing test, alkaline solution and dilute acid; concentrated sulphuric acid were used for phytochemical analysis. Antibacterial screening of the extracts was conducted using the disc gel diffusion method in E. coli, S. aureus and B. cereus clinical strains. In order to evaluate acute toxicity and its effects on haematological and biochemical parameters; 15 albino rats were grouped into five groups: I (powder of aqueous extract of Chlorella vulgaris), II (powder of methanol extract of Chlorella vulgaris), III (powder of aqueous extract of Spirulina platensis), IV (powder of methanol extract of Spirulina platensis) and V (control). The dosage was 25g/day/rat. After six days, haematological and biochemical parameters and gross pathologic changes were evaluated. Results: Alkaloids and flavonoids were detected from the methanol extracts of both Chlorella vulgaris and Spirulina platensis (Arthrospira). Only cardiac glycosides and steroids were detected from Spirulina's extracts. Chlorella vulgaris extracts significantly inhibited B. cereus. Rats fed with Chlorella vulgaris and Spirulina platensis powder showed an increase in white blood cell counts and haemoglobin level compared to negative control rats (p<0.001). Serum glumatic oxalate transaminase (SGOT) and serum glutamate pyruvate transaminase (SGPT) had normal values but significative differences between groups (p<0.001). Conclusion: This powder is rich in bioactive phytochemicals but only Chlorella's extracts have shown antibacterial effect. Signs of toxicity weren't found in any parameter.
Objetivos: Describir la toxicidad aguda, efecto antibacteriano y análisis fitoquímico de los polvos de Chlorella vulgaris y Spirulina platensis. Materiales y métodos: Se realizaron las pruebas de FeCl3, Keller Killiani, de saponinas, solución alcalina y de concentración de ácido sulfúrico para el análisis fitoquímico. El efecto antibacteriano de los extractos fue evaluado mediante el método de difusión con discos en cepas de E. coli, S. aureus y B. cereus. Para evaluar la toxicidad aguda y los efectos del polvo en parámetros hematológicos y bioquímicos, se agruparon 15 ratas albinas en cinco grupos: I (polvo de extracto acuoso de Chlorella vulgaris); II (polvo de extracto metanólico de Chlorella vulgaris); III (polvo de extracto acuoso de Spirulina platensis); IV (polvo de extracto metanólico de Spirulina platensis), y V (grupo control). La dosis usada fue de 25 g/día/rata. Después de seis días, se evaluaron todos los parámetros y cambios macroscópicos en los órganos. Resultados: Se encontraron alcaloides y flavonoides en los extractos metanólicos de Chlorella vulgaris y Spirulina platensis (Arthrospira). Se detectaron glucósidos cardiacos y esteroides en los extractos de Spirulina platensis. Los extractos de Chlorella vulgaris inhibieron el crecimiento de Bacillus cereus. Las ratas alimentadas con los polvos de Chlorella vulgaris y Spirulina platensis incrementaron el conteo de leucocitos y los valores de hemoglobina comparados con el grupo control (p<0,001). Las transaminasas (SGOT y SGPT) se encontraron en valores normales, pero con diferencias significativas entre los grupos (p<0,001). Conclusiones: Estos polvos son ricos en componentes fitoquímicos activos, pero solo los extractos de Chorella vulgaris mostraron efecto antibacteriano. No se encontraron signos de toxicidad aguda en ningún parámetro.
Assuntos
Animais , Ratos , Chlorella vulgaris/química , Testes de Sensibilidade a Antimicrobianos por Disco-Difusão , Compostos Fitoquímicos , Extratos Vegetais/toxicidade , Modelos AnimaisRESUMO
Introdução: Para a correta reparação das feridas, as diversas fases do processo de cicatrização devem ocorrer na sequencia correta, numa intensidade ideal. Vários fatores afetam a cicatrização das feridas ao interferir em uma ou mais fases deste processo, tal como, a presença de infecção. Objetivo geral: Analisar as cepas de Pseudomonas aeruginosa encontradas nas feridas crônicas tratadas com gel de carboximetilcelulose a 2% ou com placa de poliuretano. Método: Pesquisa observacional descritiva, com abordagem quantitativa, realizada através da coleta de material biológico de feridas crônicas de pacientes atendidos em serviços ambulatoriais, empregando swabs. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa (Hospital Universitário Antônio Pedro UFF) com número de parecer 815.353. As cepas de P. aeruginosa foram identificadas por MALDI-TOF MS, submetidas a testes de susceptibilidade aos antimicrobianos, identificação de genes de virulência através de PCR e tipagem molecular através de PFGE. Resultados: Das 43 feridas a partir das quais foramcoletados swabs, em 31 (72,09%) obteve-se isolamento de P. aeruginosa (foram identificadas 48 cepas). Estas feridas têm 3,6 vezes mais chances de desenvolverem infecção quando comparadas àquelas a partir das quais esse microrganismo não foi isolado. As cepas isoladas dos pacientes em uso de gel de carboximetilcelulose a 2% apresentaram maiores taxas de resistência a gentamicina e ciprofloxacino (ambos com 7,89%). Já as cepas isoladas dos pacientes tratados com placa de poliuretano, destacaram-se pela resistência a ciprofloxacino (90%). Foram identificadas três cepas multirresistentes de duas feridas tratadas com placa de poliuretano impregnada com prata. Foram positivas para presença do gene exoS 26 cepas (54,16%), e 13 (27,08%), para o gene exoU. Observou-se mesmo perfil de PFGE entre as cepas coletadas em diferentes momentos de onze pacientes, enquanto que em seis pacientes as cepas coletadas em diferentes momentos foram distintas. Não houve semelhança de padrões de fragmentação de DNA entre cepas derivadas de pacientes diferentes. Conclusão: A maioria das feridas não apresentava sinais clínicos de infecção. Foram identificadas 48 cepas de P. aeruginosa. O isolamento deste microrganismo é fator de risco para desenvolvimento de infecção. As cepas de P. aeruginosa têm baixos índices de resistência antimicrobiana, com apenas três cepas multiresistentes. Os desbridamentos realizados nas feridas crônicas não têm sido efetivos para descolonização de P. aeruginosa, já que um mesmo clone bacteriano foi identificado na ferida em diferentes momentos, na maioria dos casos
Introduction: For proper wound healing, various stages of the healing process must occur in a correct sequence and an ideal intensity. Several factors affect the wounf healing on one or more phases of this process, such as the presence of infection. General objective: To analyze Pseudomonas aeruginosa strains found in chronic wounds treated with 2% carboxymethylcellulose gel or polyurethane plate. Method: Descriptive observational research with a quantitative approach, carried out through the collection of biological material of chronic wounds of patients attended in outpatient services, using swabs. The study was approved by the Research Ethics Committee (Academic Hospital Antonio Pedro - UFF) with number 815.353. P. aeruginosa strains were identified by MALDI-TOF MS, subjected to antimicrobial susceptibility testing, identification of virulence genes by PCR and molecular typing by PFGE. Results: Of the 43 wounds from which swabs were collected, at 31 (72.09%) was obtained isolation of P. aeruginosa (48 strains have been identified). These wounds are 3.6 times more likely to develop infection when compared to those from which this microorganism was not identified. The strains isolated from patients using 2% carboxymethyl cellulose gel showed more resistance rates to gentamicin and ciprofloxacin (both 7.89%). Already the strains isolated from patients treated with polyurethane plate, highlighted by the resistance to ciprofloxacin (90%). Three multiresistant strains were identified from two wounds treated with polyurethane plate impregnated with silver. 26 strains (54.16%) were positive for the presence of exoS gene and 13 (27.08%), for the exoU gene. It was observed even PFGE profile among strains collected at different times of eleven patients, while in six patients, strains collected at different times were different. There was no resemblance DNA fragmentation patterns among strains derived from different patients. Conclusion: Most of the wounds showed no clinical signs of infection. 48 strains of P. aeruginosa have been identified. The isolation of this microorganism is a risk factor for development of infection in chronic wounds. Strains of P. aeruginosa demonstrated low antimicrobial resistance rates and only three multi-resistant strains were identified. The debridement performed in chronic wounds is not effective for removing colonization by P. aeruginosa, because same bacterials clones was identified in the wound swabs collected in same patients at different times in most cases
Assuntos
Testes de Sensibilidade a Antimicrobianos por Disco-Difusão , Resistência Microbiana a Medicamentos , Enfermagem , Pseudomonas aeruginosa , Úlcera , Infecção dos FerimentosRESUMO
Este estudo teve como objetivo analisar a presença de cepas de Staphylococcus aureus nas lesões cutâneas crônicas tratadas com hidrogel a 2% e placa de poliuretano. Para tal, foi realizada pesquisa descritiva, com abordagem quantitativa, tendo como campo de pesquisa o Ambulatório de Reparo de Feridas do Hospital Universitário Antônio Pedro (HUAP/UFF) e a Policlínica Comunitária da Engenhoca (PCE), ambos localizados na cidade de Niterói, RJ. A análise microbiológica foi realizada no Laboratório de Controle Microbiológico da Faculdade de Farmácia da Universidade Federal Fluminense (UFF) e no Instituto de Microbiologia Paulo de Góes da Universidade Federal do Rio de Janeiro (UFRJ). A coleta de dados foi realizada em duas etapas, a primeira relacionada ao exame clínico com a identificação do paciente e descrição clínica das lesões e a segunda relacionada à coleta do espécime clínico utilizando-se como instrumento de coleta o swab. Todas as cepas de S. aureus analisadas foram identificadas por MALDI-TOF e a suscetibilidade a antimicrobianos foi determinada pelo teste de disco-difusão em meio sólido, seguindo as normas recomendadas do CLSI (Clinical and Laboratory Standards Institute). A reação em cadeia da polimerase (PCR) foi empregada na detecção do gene mecA e genes lukF-PV e lukS-PV. A diversidade clonal foi verificada pelo PFGE (pulsed-field gel electrophoresis). O S. aureus foi detectado em 82,9% (29/35) dos pacientes em uso de hidrogel e em 100% (8/8) dos pacientes em uso de placa de poliuretano. Os pacientes em uso de placa de poliuretano com prata apresentaram mais sinais clínicos de infecção quando comparados aos pacientes em uso de hidrogel a 2%, principalmente pela presença do exsudato purulento. A razão de prevalência demonstrou que os pacientes que usaram a placa de poliuretano com prata tiveram pelo menos 3,6 vezes maior chance de apresentarem infecção nas feridas quando comparados com os pacientes em uso de hidrogel. A maioria dos S. aureus identificados, em ambos os campos de pesquisa, apresentou resistência à penicilina, meticilina, eritromicina e clindamicina. Em cinco pacientes (10 cepas- 20%) foi observada amplificação para o gene mecA, demonstrando a colonização por MRSA. Não foi observada amplificação para os genes lukF-PV e lukS-PV. Embora tenha sido detectada grande diversidade genética entre as cepas analisadas, o mesmo padrão se repetiu entre os S. aureus coletados em dois momentos diferentes nos mesmos pacientes. No entanto, as amostras 1 e 32/32* apresentaram o mesmo padrão de fragmentação de DNA pelo PFGE. Através da razão de prevalência, determinou-se que os pacientes com MSSA têm 16 vezes mais chance de ter infecção em feridas quando comparados aos pacientes com MRSA. Assim, o tratamento com hidrogel a 2% ou placa de poliuretano não interferiu na colonização por S. aureus. Além disso, verificamos que o uso de placa de poliuretano com prata não é indicado para feridas infectadas quando o paciente possuir como comorbidades hipertensão arterial e insuficiência venosa crônica
This study aimed to analyze the presence of Staphylococcus aureus in chronic wounds treated with hydrogel 2% and polyurethane plate. To do this, was done a descriptive study with a quantitative approach. The field research was the Wound Repair Clinic at the University Hospital Antônio Pedro (HUAP / UFF) and the Community Polyclinic of the Engenhoca, both located in the city of Niterói, RJ. The microbiological analysis was conducted at the Laboratory of Microbiological Control of the Faculty of Pharmacy of the University Federal Fluminense (UFF) and the Institute of Microbiology Paulo de Góes of the University Federal of the Rio de Janeiro (UFRJ). Data collection was carried out in stages, the first related to the clinical examination with the patient identification and clinical description of the wounds and the other step related to the collection of the clinical specimen using the swab. All strains of S. aureus analyzed were identified by MALDI-TOF and susceptibility to antibiotics was determined by disk diffusion test on solid medium following the standards recommended by CLSI (Clinical and Laboratory Standards Institute). The polymerase chain reaction (PCR) was used in the detection of the mecA gene and lukF-PV and luks-PV genes. The clonal diversity was verified by PFGE (pulsed-field gel electrophoresis). The S. aureus was detected in 82.9% (29/35) of patients using hydrogel and in 100% (8/8) the patients using polyurethane plate. Patients using polyurethane plate with silver presented more clinical signs of infection when compared to patients using hydrogel 2%, mainly by the presence of purulent exudate. The prevalence ratio showed that patients who used polyurethane plate with silver had at least 3.6 times more chance to have infection in the wound when compared to patients using hydrogel. Most S. aureus identified in both research fields presented resistance to penicillin, methicillin, erythromycin and clindamycin. Five patients (10 strains - 20%) were observed amplification for the gen mecA demonstranting colonization by MRSA. There was no amplification for lukF-PV and lukS-PV genes. Although was detected a big genetic diversity among the strains analyzed, the same pattern repeated among the S. aureus collected at two different times from the same patients. However, samples 1 and 32/32* showed the same fragmentation pattern by PFGE. Through the prevalence ratio identified that patients with MSSA had 16 times more likely to have infection in wounds when compared to patients with MRSA. Thus, the treatment with hydrogel 2% or polyurethane board did not interfered in the colonization by S. aureus. In addition, we perceived that the use of polyurethane plate with silver is not indicated for infected wounds when patients had comorbidities such as hypertension and chronic venous insufficiency
Assuntos
Resistência Microbiana a Medicamentos , Enfermagem , Staphylococcus aureus , Úlcera , Cicatrização , Infecção dos FerimentosRESUMO
Objetivo: el objetivo de este estudio fue analizar el genotipo y susceptibilidad antimicrobiana de Pseudomonas aeruginosa de pacientes con fibrosis quística y otras patologías. Materiales y métodos: se analizaron 20 aislados de pacientes con fibrosis quística y 20 de pacientes con otras enfermedades por medio de la prueba de susceptibilidad antimicrobiana por microdilución en caldo y técnica del ADN polimorfo amplificado aleatorio. Resultados: se observó que los aislados de pacientes con fibrosis quística presentaron mayor resistencia (56 %) en comparación con aislados de pacientes sin fibrosis quística (25 %). Los antimicrobianos más efectivos en ambos grupos fueron cefepima, ceftriaxona y meropenem. Desde el punto de vista genotípico, se observa heterogeneidad entre las cepas de pacientes con fibrosis quística y dos grupos con cepas idénticas de origen hospitalario, lo que sugiere una posible transmisión cruzada. Conclusión: Concluimos que los porcentajes de resistencia de Pseudomonas aeruginosa en este estudio son altas, y este hallazgo se acentúa en el caso de pacientes con fibrosis quística, lo cual deja muy pocas opciones de tratamiento. La tipificación por técnica del ADN polimórfico amplificado aleatorio permitió conocer la variabilidad de genotipos para tener control sobre la transmisión de cepas, lo cual constituye un tópico de importancia en el sistema de salud y el mejoramiento de la calidad de vida de los pacientes.
Objective: Our aim was to analyze genotype and antimicrobial susceptibility of Pseudo-monas aeruginosa from cystic fibrosis patients and other diseases. Materials and methods: We analyzed 20 isolates from cystic fibrosis patients and 20 from patients with other diseases by dilution antimicrobial susceptibility test and random amplified polymorphic DNA technique. Results: We found that isolates from cystic fibrosis patients had higher resistance (56 %) than isolates from patients without cystic fibrosis (26 %). The most effective antimicrobi-als in both groups were cefepime, ceftriaxone and meropenem. With regard to the geno-type, we observed heterogeneity between strains from cystic fibrosis patients and two clus-ters with identical strains from hospital origin, suggesting a possible cross transmission. Conclusion: We concluded that the resistance rate of Pseudomonas aeruginosa in this study was high and this finding is accentuated in patients with cystic fibrosis, leaving few treatment options. Typification by random amplified polymorphic DNA technique allowed us to know the variability of genotypes to control strain transmission; this is an important topic to optimize health services and the quality of life of our patients.
RESUMO
Os testes de sensibilidade aos antifúngicos realizados pelo método de disco-difusão em ágar são práticos e bem conhecidos pelos profissionais do laboratório de microbiologia, entretanto apresentam particularidades que os diferem dos testes realizados para bactérias. O objetivo deste trabalho foi comparar as técnicas de disco-difusão em ágar e microdiluição em caldo na determinação da sensibilidade in vitro de isolados de Candida spp. a antifúngicos. Foram analisados 63 isolados clínicos de leveduras, que incluíram as espécies Candida parapsilosis complex (n = 20), Candida albicans (n = 18), Candida tropicalis (n = 14), Candida glabrata (n = 4), Candida krusei (n = 4), Candida kefyr (n = 2) e Candida lusitaniae (n = 1). As técnicas de disco-difusão em ágar e de microdiluição em caldo foram utilizadas para testar a sensibilidade em relação aos antifúngicos fluconazol, itraconazol e anfotericina B. A sensibilidade ao voriconazol foi determinada somente pela técnica de disco-difusão. Os halos ao redor dos discos de fluconazol variaram de 14 mm a 50 mm, e a CIM de 0,125 µg/mL a 32 µg/mL; para itraconazol, os halos variaram de 9 mm a 27 mm e a CIM de 0,03 µg/mL a 0,25 µg/mL; para anfotericina B, 9 mm a 21mm e 0,5 µg/mL a 2 µg/mL, respectivamente; para voriconazol, o diâmetro dos halos variaram de 19 mm a 50 mm. Para as três espécies, C. albicans, C. parapsilosis e C. tropicalis, a técnica de disco-difusão apresentou boa concordância com a microdiluição, especialmente em relação ao fluconazol, representando, assim, um recurso importante para os laboratórios reportarem os resultados dos testes de sensibilidade dos isolados dessas espécies ao fluconazol.
Antimicrobial susceptibility tests performed by disk diffusion method are practical and well known by professionals that work in the microbiology laboratory. The disk diffusion methodology used to verify the susceptibility of fungi to antifungal agents, however, has characteristics that differ from the tests for bacteria. The objective of this study was to evaluate the disk diffusion method to determine the in vitro susceptibility to antifungal agents of Candida species. We analyzed 63 clinical isolates of yeasts, which included Candida parapsilosis complex species (n = 20), Candida albicans (n = 18), Candida tropicalis (n = 14), Candida glabrata (n = 4), Candida krusei (n = 4), Candida kefyr (n = 2) and Candida lusitaniae (n = 1). The susceptibility tests to antifungal drugs was performed by disk diffusion methods and broth microdilution for antifungal fluconazole, itraconazole and amphotericin B. Voriconazole was used to test the susceptibility only by the disk diffusion method. The inhibition halos of growth around disks of fluconazole ranged from 14 mm to 50 mm and the MIC from 0.125 µg/mL to 32 µg/mL, for itraconazole, halos ranged from 9 mm to 27 mm and the MIC from 0.03 µg/mL to 0.25 µg/mL, for amphotericin B, 9 mm to 21 mm and 0.5 µg/mL to 2 µg/mL, respectively. The diameter of voriconazole disks varied from 19 mm to 50 mm. For the three species, C. albicans, C. parapsilosis and C. tropicalis, the disk diffusion method showed good agreement with the microdilution, especially to fluconazole, thus representing an important resource for medical laboratories reporting results of susceptibility testing of isolates of these species to fluconazole.
Assuntos
Candida , Testes de Sensibilidade Microbiana , Fluconazol , Ágar , Testes de Sensibilidade a Antimicrobianos por Disco-Difusão , AntifúngicosRESUMO
This study evaluated the pH, calcium ion release and antimicrobial activity of EndoBinder (EB), containing different radiopacifiers: bismuth oxide (Bi2O3), zinc oxide (ZnO) or zirconium oxide (ZrO2), in comparison to MTA. For pH and calcium ion release tests, 5 specimens per group (n = 5) were immersed into 10 mL of distilled and deionized water at 37°C. After 2, 4, 12, 24, 48 h; 7, 14 and 28 days, the pH was measured and calcium ion release quantified in an atomic absorption spectrophotometer. For antimicrobial activity, the cements were tested against S. aureus, E. coli, E. faecalis and C. albicans, in triplicate. MTA presented higher values for pH and calcium ion release than the other groups, however, with no statistically significant difference after 28 days (p > 0.05); and the largest inhibition halos for all strains, with no significant difference (E. coli and E. faecalis) for pure EB and EB + Bi2O3 (p > 0.05). EB presented similar performance to that of MTA as regards pH and calcium ion release; however, when ZnO and ZrO2 were used, EB did not present antimicrobial activity against some strains.
Assuntos
Compostos de Alumínio/química , Anti-Infecciosos/química , Compostos de Cálcio/química , Cimentos Dentários/química , Análise de Variância , Compostos de Alumínio/farmacologia , Anti-Infecciosos/farmacologia , Bismuto/química , Bismuto/farmacologia , Compostos de Cálcio/farmacologia , Candida albicans/efeitos dos fármacos , Combinação de Medicamentos , Cimentos Dentários/farmacologia , Enterococcus faecalis/efeitos dos fármacos , Escherichia coli/efeitos dos fármacos , Concentração de Íons de Hidrogênio , Teste de Materiais , Óxidos/química , Óxidos/farmacologia , Espectrofotometria Atômica , Silicatos/química , Silicatos/farmacologia , Staphylococcus aureus/efeitos dos fármacos , Fatores de Tempo , Óxido de Zinco/química , Óxido de Zinco/farmacologia , Zircônio/química , Zircônio/farmacologiaRESUMO
A esporotricose é uma infecção subaguda ou crônica, causada por fungos pertencentes ao Complexo Sporothrix. Relato do caso: esporotricose de localização nasal foi tratada com iodeto de potássio e como não se obteve sucesso, reiniciou-se o tratamento com associação de iodeto de potássio e itraconazol. Porém, ocorreu nova recidiva. As culturas dos exames micológicos foram submetidas a ensaios de atividade antifúngica in vitro para auxiliar no tratamento. A terbinafina foi o antifúngico que apresentou melhores resultados, por isso, o tratamento foi reiniciado com este antifúngico e, após dois anos do término do mesmo, não recidivou. Adicionalmente, ambas as culturas foram comparadas por RAPD, obtendo padrões de fragmentos distintos, indicando que os isolados são diferentes ou demonstrando um processo microevolutivo do microrganismo.
Sporotrichosis is a chronic subacute infection caused by fungi belonging to the Sporothrix Complex. In the present clinical case, nasal sporotrichosis was treated with potassium iodide. This was unsuccessful, and the treatment was restarted with a combination of potassium iodide and itraconazole. This however resulted in a further recurrence of the infection. The mycological cultures were tested in vitro for antifungal activity to assist in treatment. Terbinafine, an antifungal drug, produced the best results and was therefore used for the rest of the treatment course, with no recurrence after two years of its completion. In addition, both cultures were compared using RAPD and different fragment patterns were observed. This indicated that the isolates were either different or indicated a microevolutionary process of this microorganism.
Assuntos
Idoso , Feminino , Humanos , Antifúngicos/uso terapêutico , Naftalenos/uso terapêutico , Doenças Nasais/tratamento farmacológico , Esporotricose/tratamento farmacológico , Testes de Sensibilidade Microbiana , Doenças Nasais/microbiologia , Sporothrix/isolamento & purificação , Esporotricose/microbiologiaRESUMO
Introducción: la sensibilidad antifúngica in vitro en hongos filamentosos no ha tenido el mismo desarrollo que en levaduras. Se dispone de limitada información sobre la susceptibilidad en este tipo de aislamientos en Colombia. Materiales y métodos: se determinó la actividad in vitro de fluconazol, voriconazol, itraconazol, anfotericina B y caspofungina mediante el método de E-Test, de los géneros Aspergillus (36 A. fumigatus, 12 A. flavus, 9 A. niger, 6 A. terreus, 4 A. nidulans y 1 A. versicolor) e hifomicetes hialinos (9 Fusarium sp., 2 Geotrichum sp. y 2 Paecilomyces sp.), provenientes en su mayoría de lavados broncoalveolares (30%) y biopsias pulmonares (36%); 9% provenían de hemocultivos. Resultados: el perfil de resistencia general fue 28% para itraconazol, 15% para caspofungina, 14% para anfotericina B y 5% para voriconazol. En general, todos los aislamientos presentaron una sensibilidad disminuida para fluconazol e itraconazol. La mejor actividad farmacológica la presentaron voriconazol, caspofungina y anfotericina B. Fusarium sp. presentó una mayor actividad con el voriconazol. Se encontraron diferencias entre el tipo de micelio (Aspergillus vs no Aspergillus) y la susceptibilidad a voriconazol, anfotericina B y caspofungina. Conclusión: en general, los antimicóticos disponibles para el tratamiento de infecciones por miceliales muestran una sensibilidad disminuida in vitro en relación con el género y la especie identificada.
Introduction: fungal susceptibility against micelial fungi has not been developed at the same pace as susceptibility against yeasts. Scarce information is available about that kind of isolates in Colombia. Materials and methods: in vitro susceptibility against micelial isolates from patients with cancer was determined. The E-test method was used to find out susceptibility against fluconazole, voriconazole, itraconazole, amphotericin B, and caspofungin. Isolates of the genera Aspergillus (36 A. fumigatus, 12 A. flavus, 9 A. niger, 6 A. terreus, 4 A. nidulans and one A. versicolor isolate), Fusarium (n=9), Geotrichum and Paecilomyces (n=2 each one) obtained from patients with cancer were tested. These isolates were obtained from bronchoalveolar lavage (30%), pulmonary biopsies (36%) and bloodstream infections (9%). Results: The general pattern of resistance was 28% against intraconazole, 15% against caspofungin, 14% against amphotericin B, and 5% against voriconazole. In general, susceptibility against fluconazole and itraconazole showed a diminishing trend. Voriconazole, caspofungin, and amphotericin B showed the best pharmacologic potency. Fusarium sp. presented a higher activity level against voriconazole. There were differences in the susceptibility against voriconazole, anphotericin B, and caspofungin depending on the type of micelial isolate (Aspergillus vs. Non- Aspergillus). Conclusion: In general, the available antifungal treatments against mycelial fungi identified in the cancer center show diminished susceptibility.
Assuntos
Humanos , Testes de Sensibilidade Microbiana , Testes de Sensibilidade a Antimicrobianos por Disco-Difusão , Fungos , Neoplasias , Aspergilose , Aspergillus , Resistência a Medicamentos , AntifúngicosRESUMO
Tigecycline is a glicylcicline with broad antimicrobial spectrum. Susceptibility testing to this drug for Acinetobacter is difficult in hospitals due to the utilization of the disk diffusion method. FDA break points have shown an unacceptable rate of errors (23 percent) for disk diffusion versus broth microdilution in American studies and overcall of resistance depending on the brand of Mueller Hinton agar used. Modifications to these FDA break points have been proposed, but there is not enough evidence yet. Data from a multicenter study from Chile allowed the evaluation of the characteristics of the agar used for susceptibility testing and the utility of E-test as an alternative MIC method for Acinetobacter. The Mueller Hinton agar brand is an important factor that affects disk diffusion method results. There is very good correlation between broth microdilution and E-test for the susceptibility category as well as for MIC determination. The intermedíate and resistant results obtained with disk diffusion method should be checked by using E-test.
Tigeciclina es una glicilciclina de amplio espectro antimicrobiano. La determinación de la susceptibilidad a este fármaco presenta dificultades en el laboratorio asistencial al utilizar la técnica de difusión por disco para Acinetobacter spp. Los puntos de corte -según la (FDA- han mostrado una tasa inaceptable de errores (23 por ciento) en comparación con el método de micro-dilución en caldo en estudios americanos, diversas evaluaciones demuestran que existe una sobreestimación de resistencia in vitro dependiendo de las características del agar Mueller Hinton utilizado. Se han propuesto modificaciones a los puntos de corte pero no se han oficializado por insuficientes evidencias. Los datos de un estudio multicéntrico realizado en Chile permitieron evaluar la influencia de las distintas marcas de medios de cultivo en el tamaño de los halos y la utilidad de la epsilometría (E-test®) como método CIM para Acinetobacter sp. La marca de agar Mueller Hinton y otros factores propios del medio dificultan la determinación de la susceptibilidad a tigeciclina utilizando difusión por disco. Existe muy buena correlación entre la micro-dilución en caldo y el E- test®, tanto para la categoría de susceptibilidad como para la CIM. Por esto, se sugiere que los resultados intermedios o resistentes obtenidos por difusión en agar para A. baumannii sean comprobados mediante el uso de E-test®.
Assuntos
Humanos , Testes de Sensibilidade Microbiana , Acinetobacter baumannii/efeitos dos fármacos , Tigeciclina/farmacologia , Antibacterianos/farmacologia , Testes de Sensibilidade a Antimicrobianos por Disco-DifusãoRESUMO
The present study aimed at investigating the susceptibility of the microorganisms Pseudomonas aeruginosa, Salmonella typhi, Escherichia coli, Staphylococcus aureus, and Bacillus subtilis to ethanolic extracts of propolis (EEP) from three regions of Kenya (Taita, Tana and Samburu). Propolis was extracted using four different concentrations of ethanol: pure, 70%, 50%, and 30%. Ethanol (70%) and Streptomycin were used as controls. The agar diffusion method using filter paper disks was employed. Antibacterial activity was determined as an equivalent of the inhibition zones diameters (in millimeters) after incubation at 37°C for 24h. Significant differences in the antibacterial activities of propolis were observed among the three regions, depending on the test microorganisms and on the procedure used for the preparation of propolis extract. Bacillus subtilis and Staphylococcus aureus were the most susceptible bacteria and 70% EEP had the best antibacterial effect.
RESUMO
The present study aimed at investigating the susceptibility of the microorganisms Pseudomonas aeruginosa, Salmonella typhi, Escherichia coli, Staphylococcus aureus, and Bacillus subtilis to ethanolic extracts of propolis (EEP) from three regions of Kenya (Taita, Tana and Samburu). Propolis was extracted using four different concentrations of ethanol: pure, 70 percent, 50 percent, and 30 percent. Ethanol (70 percent) and Streptomycin were used as controls. The agar diffusion method using filter paper disks was employed. Antibacterial activity was determined as an equivalent of the inhibition zones diameters (in millimeters) after incubation at 37°C for 24h. Significant differences in the antibacterial activities of propolis were observed among the three regions, depending on the test microorganisms and on the procedure used for the preparation of propolis extract. Bacillus subtilis and Staphylococcus aureus were the most susceptible bacteria and 70 percent EEP had the best antibacterial effect.(AU)