RESUMO
Objetivo: Describir la sensibilidad antibiótica de gérmenes prevalentes causantes de infecciones del tracto urinario en un hospital general. Material y métodos: Se realizó un estudio descriptivo, retrospectivo de serie de casos en el Hospital Nacional Cayetano Heredia. Se analizaron los urocultivos positivos realizados en los meses de enero a junio del año 2008. Resultados: De 1249 urocultivos positivos, se aisló en pacientes no hospitalizados; Escherichia coli 76 por ciento seguido de Klebsiella spp. 5 por ciento y Citrobacter sp. 3 por ciento. Escherichia coli fue sensible a amikacina, nitrofurantoína, ceftriaxona y ciprofloxacino en 93,4 por ciento, 88,6 por ciento, 78 por ciento y 44,5 por ciento respectivamente. En pacientes hospitalizados la frecuencia fue; Escherichia coli 49 por ciento seguido de Enterococcus spp. 11,39 por ciento y Klebsiella spp. 8,42 por ciento siendo Escherichia coli sensible a amikacina, nitrofurantoína, ceftriaxona y ciprofloxacino en 88,89 por ciento, 75,26 por ciento, 43,88 por ciento y26,04 por ciento, respectivamente. Nitrofurantoína obtuvo resistencias bajas en hospitalizados 16,49 por ciento y en no hospitalizados 6.48 por ciento para Escherichia coli. Conclusiones: Se observó que amikacina vuelve a ser una buena opción como tratamiento empírico; así mismo hubo aumento en la resistencia a antibióticos comúnmente usados, sin embargo antibióticos poco usados como nitrofurantoína tienen mejores niveles de sensibilidad para Escherichia coli.
Objective: To describe the antibiotic sensitivity of positive urine cultures performed in general hospital. Material and methods: Descriptive and retrospective case series was performed at the Hospital Nacional Cayetano Heredia. We revised the urine positive cultures from January until June, 2008. Results: From a total of 1249 positive urine cultures taken from non-hospitalized patients (1049 cases) the following was isolated: Escherichia coli 76 per cent followed by Klebsiella spp. 5 per cent and Citrobacter sp. 3 per cent. Escherichia coli were found sensitive to amikacina, nitrofurantoína,ceftriaxona and ciprofloxacin in 93.5 per cent, 88 per cent, 78 per cent and 44.59 per cent respectively. In hospitalized patients (204 cases), the frequency was 49.01 per cent for Escherichia coli followed by 11.39 per cent for Enterococcus spp. and 8.42 per cent. for Klebsiella spp. Escherichia coli was found sensitive to amikacina (88.89 per cent), nitrofurantoína (75.26 per cent), ceftriaxona (42.88 per cent) and ciprofloxacin (26.04 per cent). Nitrofurantoin showed low resistance in hospitalized patients (16.49 per cent), as in for nonhospitalized patients (6.48 per cent) Escherichia coli. Conclusions: Amikacin is a good option for empiric treatment. We also found a high resistance percentage in strains isolated with the most common used antibiotics. Nevertheless, less used antibiotics as Nitrofurantoin have a higher sensitivity percentage against Escherichia coli.
Assuntos
Humanos , Masculino , Feminino , Antibacterianos , Escherichia coli , Resistência Microbiana a Medicamentos , Infecções Urinárias , Teste na Urina com Bactérias Cobertas por Anticorpos , Sensibilidade e Especificidade , Epidemiologia Descritiva , Estudos Retrospectivos , Relatos de CasosRESUMO
Se realizo un estudio bacteriològico en muestras de orina de pacientes atendidos en el Hospital San Gabriel durante el periodo comprendido entre mayo de 1994 a septiembre de 1995. El diagnòstico clìnico fuè ITU (Infecciòn del tarcto urinario); de dichas muestras, 414 evidenciaron una bacteria como microorganismo causal. El estudio realizado, demuestra a E. coli como agente causal màs frecuente en ITU (88,4 porciento), lo cual concuerda con reportes internacionales previos
Assuntos
Humanos , Masculino , Adulto , Infecções Urinárias/diagnóstico , Incidência , Escherichia coli/isolamento & purificação , Técnicas Bacteriológicas , Uretra/microbiologia , Bexiga Urinária/parasitologia , Teste na Urina com Bactérias Cobertas por Anticorpos/enfermagem , Próstata/parasitologiaRESUMO
A simple and rapid staphylococcal coagglutination test for the detection of Toxoplasma gondii antigens in mice urine is described. A suspension of protein-A containing Staphylococcus aureus coated with rabbit hyperimmune serum was used as reagent. The sensitivity of the antigen assay was found to be at least 118 ng of the antigen protein per ml. No coagglutination was observed when the reagent was challenged against antigenic solutions of other parasites. The suitability of the method for detecting antigens of T. gondii in urine samples was studied by experimental toxoplasma infection in mice. Before the staphylococcal test, the urine samples were double serially diluted in 0.1 M PBS. From the second day on all samples from infected mice were positive at 1/16 dilution. At this dilution, all samples from non infected mice were negative or did not produce coagglutination. This method might be used in the rapid etiological diagnosis also in human cases of acute toxoplasmosis
Assuntos
Camundongos , Animais , Antígenos de Protozoários/urina , Toxoplasma/imunologia , Toxoplasmose/diagnóstico , Testes de Aglutinação , Teste na Urina com Bactérias Cobertas por AnticorposRESUMO
One hundred thirty-eight patients with pyelonephritis were treated with norfloxacin, 400 mg twice daily. Women accounted for 74% of cases, and Escherichia coli was the predominant pathogen, accounting for 51% of organisms. Tests for antibody-coated bacteria (ACB) were performed in 48% of patients, and 72% (48 of 67) were positive. Forty percent of the patients had temperatures greater than 37.6 degrees C at the time of study entry. Patients who had both fevers and positive ACB tests had cure rates similar to those of afebrile, ACB-negative patients. Norfloxacin was also highly effective in the treatment of multiply resistant, nosocomial urinary tract infections (UTIs), in which Pseudomonas aeruginosa and E. coli predominated. It is concluded that, when used appropriately, i.e., in nonbacteremic patients who are able to absorb oral drugs, norfloxacin is a highly effective alternative modality in the therapy of certain UTIs that historically have been treated with parenteral antibiotics.
Assuntos
Norfloxacino/uso terapêutico , Pielonefrite/tratamento farmacológico , Infecções Urinárias/tratamento farmacológico , Administração Oral , Teste na Urina com Bactérias Cobertas por Anticorpos , Ensaios Clínicos como Assunto , Infecção Hospitalar/tratamento farmacológico , Feminino , Humanos , Infusões Parenterais , Masculino , Norfloxacino/administração & dosagem , Infecções Urinárias/microbiologiaRESUMO
Forty-nine ambulatory children between 2-1/2 and 12 years of age with acute, clinically uncomplicated urinary tract infections caused by susceptible organisms were randomized to receive a single dose of amoxicillin based on weight or a 10-day course of amoxicillin therapy (conventional therapy). Patients receiving single doses of amoxicillin had a cure rate of 63%, which compares unfavorably with the cure rate of 92% in patients given conventional therapy. A failure of single-dose therapy predicted underlying radiologic abnormalities with a sensitivity of 60% and a specificity of 58%, making it a poor screening test for detecting those patients at risk for renal parenchymal damage. The antibody-coated bacteria assay had no predictive value in separating upper and lower tract disease, although it may predict underlying radiologic abnormalities. The data indicate that the response to single-dose amoxicillin therapy fails to separate upper from lower tract disease reliably and has a limited role in predicting response to conventional antimicrobial therapy.