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1.
Marta Gómara Ana Isabel López-Calleja Berta María Pilar Vela Iglesia Isabel Ferrer Cerón Antonio Rezusta López María José Revillo Pinilla 《Enfermedades infecciosas y microbiología clínica》2018,36(5):296-301
Introduction
Our objective was to characterize the enzymatic β-lactam resistance in clinical Enterobacteriaceae isolates with diminished susceptibility to carbapenems from 2013 to 2014 at Hospital Universitario Miguel Servet.Material/methods
A total of 63 clinical isolates were analyzed for the presence of carbapenemases (KPC, OXA-48 and MBL), ESBLs and AmpC enzymes by combined disk methods and PCR detection of carbapenemase-encoding and beta-lactamase-encoding genes.Results
Fifteen isolates had a phenotypic test compatible with carbapenemase production; two of these were confirmed by PCR as OXA-48 producers. ESBL detection was positive in 27 isolates (43%); plasmid-mediated AmpC was detected in nine isolates (14.2%) and derepressed AmpC β-lactamase was present in 18 isolates (28%).Conclusion
During the study period, the decreased susceptibility to carbapenems in Enterobacteriaceae in our area was not due to true carbapenemases but rather to β-lactamase activity (82.5% were ESBL or AmpC producers), probably in combination with decreased permeability of the outer membrane. 相似文献2.
Taisa Trevizani Rocchetti Katheryne Benini Martins Patricia Yoshida Faccioli Martins Rogério Antonio de Oliveira Alessandro Lia Mondelli Carlos Magno Castelo Branco Fortaleza Maria de Lourdes Ribeiro de Souza da Cunha 《The Brazilian journal of infectious diseases》2018,22(2):99-105
Introduction
Staphylococcus spp. – both S. aureus, including methicillin-resistant strains (MRSA) and coagulase negative staphylococci (CoNS) – are relevant agents of healthcare-associated infections. Therefore, the rapid recognition of MRSA and methicillin-resistant CoNS from blood stream infections is critically important for patient management. It is worth noting that inappropriate empiric therapy has been associated with higher in-hospital mortality.Material and methods
In this study we evaluated a multiplex polymerase chain reaction (multiplex PCR) standardized to detect Staphylococcus spp., S. aureus, and mecA gene-encoded oxacillin resistance directly from blood culture bottles. A total of 371 blood cultures with Gram-positive microorganisms confirmed by Gram-stain were analyzed. Results from multiplex PCR were compared to phenotypic characterization of isolates.Results
Staphylococcus aureus was detected in 85 (23.0%) blood cultures and CoNS in 286 (77.0%). There was 100% agreement between phenotypic and multiplex PCR identification. Forty-three (50.6%) of the 85 S. aureus carried the mecA gene and among the 286 CoNS, 225 (78.7%) were positive for the mecA gene.Conclusions
The multiplex PCR assay developed here was found to be sensitive, specific, rapid, and showed good agreement with the phenotypic results besides being less expensive. This PCR method could be used in clinical laboratories for rapid identification and initiation of specific and effective treatment, reducing patient mortality and morbidity. Furthermore, this method may reduce misuse of antimicrobial classes that are more expensive and toxic, thus contributing to the selection of antibiotic-resistant Staphylococcus spp. 相似文献3.
Jailton Lobo da Costa Lima Lilian Rodrigues Alves Paula Regina Luna de Araújo Jacomé João Pacífico Bezerra Neto Maria Amélia Vieira Maciel Marcia Maria Camargo de Morais 《The Brazilian journal of infectious diseases》2018,22(2):129-136
Introduction
Biofilm production is an important mechanism for the survival of Pseudomonas aeruginosa and its relationship with antimicrobial resistance represents a challenge for patient therapeutics. P. aeruginosa is an opportunistic pathogen frequently associated to nosocomial infections, especially in imunocompromised hosts.Objectives
Analyze the phenotypic biofilm production in P. aeruginosa isolates, describe clonal profiles, and analyze quorum sensing (QS) genes and the occurrence of mutations in the LasR protein of non-biofilm producing isolates.Methods
Isolates were tested for biofilm production by measuring cells adherence to the microtiter plates. Clonal profile analysis was carried out through ERIC-PCR, QS genes were by specific PCR.Results
The results showed that 77.5% of the isolates were considered biofilm producers. The results of genotyping showed 38 distinct genetic profiles. As for the occurrence of the genes, 100% of the isolates presented the lasR, rhlI and rhlR genes, and 97.5%, presented the lasI gene. In this study nine isolates were not biofilm producers. However, all presented the QS genes. Amplicons related to genes were sequenced in three of the nine non-biofilm-producing isolates (all presenting different genetic similarity profile) and aligned to the sequences of those genes in P. aeruginosa strain PAO1 (standard biofilm-producing strain). Alignment analysis showed an insertion of three nucleotides (T, C and G) causing the addition of an amino acid valine in the sequence of the LasR protein, in position 53.Conclusion
The modeling of the resulting LasR protein showed a conformational change in its structure, suggesting that this might be the reason why these isolates are unable to produce biofilm. 相似文献4.
Juan Carlos Sanz Esther Ríos Iciar Rodríguez-Avial Belén Ramos Mercedes Marín Emilia Cercenado 《Enfermedades infecciosas y microbiología clínica》2018,36(7):428-430
Introduction
The aim was to evaluate the utility of a multiplex real-time PCR to detect Streptococcus pneumoniae lytA, plyA and psaA genes in pleural fluid (PF).Methods
A collection of 81 PF samples was used. Sixty were considered positive for S. pneumoniae according to previous results (54 by an in-house lytA gene PCR and eight by universal rRNA PCR).Results
The sensitivity for detection of the lytA, plyA and psaA genes by multiplex PCR was 100% (60/60), 98.3% (59/60) and 91.7% (55/60), respectively. The detection of all three genes was negative in 21 samples formerly confirmed as negative for S. pneumoniae (100% specificity) by the other procedures (9 by in-house lytA PCR and 12 by rRNA PCR).Conclusions
The use of this multiplex PCR may be a useful option to identify S. pneumoniae directly in PF samples. 相似文献5.
Irene Fuertes de Vega Carola Baliu-Piqué Jordi Bosch Mestres Andrea Vergara Gómez Xavier Vallés Mercè Alsina Gibert 《Enfermedades infecciosas y microbiología clínica》2018,36(3):165-168
Background
There are very few data available regarding risk factors associated with antibiotic resistant-Neisseria gonorrhoeae.Methods
A study was conducted on 110 samples from 101 patients with gonococcal infection, in order to describe their characteristics and compare them with the antimicrobial susceptibility profile of their samples.Results
An association was observed between resistant infections and heterosexual men, older age, concurrent sexually transmitted infection, and unsafe sexual behaviors.Conclusion
There is a need for improved data on the risk factors associated with antibiotic resistant gonococcal infection in order to identify risk groups, and to propose public health strategies to control this infection. 相似文献6.
Rafael Oliveira dos Reis Margarida Neves Souza Maria Cristina Piccoli Cecconi Loeci Timm Nilo Ikuta Daniel Simon Jonas Michel Wolf Vagner Ricardo Lunge 《The Brazilian journal of infectious diseases》2018,22(5):424-432
Introduction
Nontyphoidal Salmonella serotypes are the main cause of human food-borne infection, including several hospitalization cases in the developing countries.Aim
To detect the main serotypes and to characterize the antibiotic resistance of human non-enteric and enteric nontyphoidal Salmonella from clinical isolates in Brazil.Methods
Salmonella serotypes were identified by microbiological and molecular methods. Susceptibility testing to antibiotics was performed by agar disk diffusion. Real-time PCRs were carried out for the detection of the genus Salmonella as well as serotypes Typhimurium and Enteritidis.Results
A total of 307 nontyphoidal Salmonella were isolated from 289 different patients in a reference laboratory (LACEN-RS) from Southern Brazil in a six-year period (2010–2015). There were 45 isolates from emerging cases and 244 from sporadic cases in hospitalized patients. Non-enteric isolates were detected in 42.6% of the patients from sources such as urine, blood and other clinical fluids. Serological and PCR-specific tests demonstrated that Typhimurium (48.4%) and Enteritidis (18.3%) were the most frequent serotypes. Typhimurium isolates were generally resistant to three or more antibiotic classes, while Enteritidis isolates to one or two classes. Typhimurium was the most frequent serotype in all samples (48.4%), mainly among the hospitalized patients (55.6%), and presented the highest rates of multidrug resistance (59.3% of the isolates of this serotype). Further, the prevalence of this serotype increased along the years of the study in comparison to other nontyphoidal Salmonella serotypes.Conclusion
Greater public health attention should be given to prevent salmonellosis in the community and in hospital settings to reduce the rates of Typhimurium strains with multidrug resistance. 相似文献7.
Antonio Gutiérrez-Pizarraya Luis Martín-Villén Luis Alcalá-Hernández Mercedes Marín Arriaza Bárbara Balandín-Moreno César Aragón-González José Ferreres-Franco Miguel Ángel Chiveli Monleón Paloma Anguita-Alonso Emilio Bouza-Santiago José Garnacho-Montero 《Enfermedades infecciosas y microbiología clínica》2018,36(4):218-221
Introduction
Our objectives were to describe the incidence, clinical characteristics, and risk factors for Clostridium difficile infection (CDI) in critically ill patients and to determine C. difficile PCR-ribotypes.Methods
Prospective, observational study in 26 Spanish ICUs. Patients with diarrhea meeting ESCMID criteria for CDI were included. Molecular characterization of isolates was performed using PCR ribotyping.Results
Of 4258 patients admitted to the ICUs, 190 (4.5%) developed diarrhea. Only 16 patients (8.4%) were diagnosed with CDI. Ribotype 078/126 (25.0%) was the most frequently identified. The mortality rate was similar in patients with ICD compared to patients with diarrhea not caused by C. difficile (p = 0.115). Chronic renal insufficiency was identified as the only factor independently associated with the development of CDI (OR 5.87, 95% CI 1.24–27.83; p = 0.026).Conclusions
The incidence of CDI in Spanish ICUs is low. Only chronic renal insufficiency was observed to be a risk factor for CDI development. 相似文献8.
Alejandra Asenjo Johannes G. Kusters Tim T. Severs Juan-Ignacio Alós 《Enfermedades infecciosas y microbiología clínica》2018,36(3):169-171
Introduction
The aim of this study was to determine the prevalence of Mycoplasma genitalium infection and the resistance to macrolides within a general population in Madrid in 2015.Methods
We collected 359 urine samples from a general population with symptoms of sexually transmitted infections (STIs). All samples underwent a real-time PCR. For the detection of macrolide resistance, a 283 bp fragment of region V of the 23S rRNA gene of M. genitalium was amplified and sequenced.Results
We found a prevalence of 3.34% of M. genitalium and a macrolide resistance rate of 20%. In males, the prevalence was 6.62% and in women 0.96%, being significantly higher in males.Conclusions
The prevalence obtained shows that it is a pathogen to consider in our environment. These findings stress the need for routine testing of M. genitalium infections and would seem to suggest the advisability of resistance testing. 相似文献9.
Ana M. Palomar Aránzazu Portillo Paula Santibáñez Sonia Santibáñez José A. Oteo 《Enfermedades infecciosas y microbiología clínica》2018,36(9):568-571
Introduction
Borrelia miyamotoi is a tick-borne pathogen belonging to the relapsing fever group. It had not been reported from Spain, but its wide distribution and the presence of the tick-vector (Ixodes ricinus) made us suspect its circulation. The aim of this study was to investigate the presence of Borrelia spp. in I. ricinus in Spain.Methods
A total of 652 I. ricinus nymphs collected in northern Spain were processed. The DNA was extracted using incubations with ammonium hydroxide. Borrelia spp. DNA was amplified using Borrelia-specific PCR assays (glpQ, 16S rRNA and flagellin genes).Results
B. miyamotoi was amplified in 4 specimens, and Borrelia burgdorferi sensu lato in 27 (8 Borrelia afzelii, 7 Borrelia garinii, 8 Borrelia lusitaniae, 3 Borrelia valaisiana and 1 B. burgdorferi sensu stricto).Conclusion
B. miyamotoi should be considered in the differential diagnoses of patients with confirmed or suspected tick-bite in Spanish endemic areas for Lyme disease. 相似文献10.
11.
Background
In recent years, the prevalence of asthma has risen in developed countries, and its extent related to a change in our indigenous microbiota. Helicobacter pylori disappearance across the population represents a fundamental change in our human microbiota and has preceded the rise in asthma prevalence.Objective
To assess the relationship between childhood asthma and Helicobacter pylori infection.Methods
Quantitative determination of Helicobacter pylori IgG among 90 asthmatic children and 90 – age and gender – matched non-atopic, non-asthmatic healthy children was performed using ELISA in serum of all participants.Results
Helicobacter pylori IgG seropositivity was found in 25.6% of asthmatics compared to 44.4% of controls. Asthmatics showed lower median Helicobacter pylori IgG titre compared to healthy controls. We also detected a significant inverse relationship between Helicobacter pylori IgG titre and asthma severity.Conclusion
Helicobacter pylori seropositivity protects against childhood asthma and inversely correlates to its clinical and functional severity. 相似文献12.
Renata N. Pires Cassia F.B. Caurio Gabriele Z. Saldanha Andreza F. Martins Alessandro C. Pasqualotto 《The Brazilian journal of infectious diseases》2018,22(4):345-346
Introduction
Clostridium difficile is an important cause of diarrhoea, particularly in patients receiving antibiotic therapy. Recent studies have shown that a substantial proportion of C. difficile infections are acquired in the community, as a zoonotic disease. Brazil is a large exporter of meat and so far no study has evaluated meat contamination with C. difficile spores.Methods
Here we analysed 80 retail meat products purchased from local supermarkets in a Brazilian metropolis (Porto Alegre, Southern Brazil). Samples from these products were grown in anaerobic conditions, and tested with a real time polymerase chain reaction test.Results
Contamination with C. difficile spores was not found in the study. Bacteria isolated from meat included Streptococcus gallolyticus, Lactobacillus plantarum, Enterococcus gallinarum and Pediococcus acidilactici.Discussion
Close vigilance is required in order to guarantee the quality of Brazilian retail meat in the long term. 相似文献13.
Antonia Sánchez-Bautista Javier Coy Patricia García-Shimizu Juan Carlos Rodríguez 《Enfermedades infecciosas y microbiología clínica》2018,36(4):229-232
Introduction
Implementation of the breakpoints established in the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines in comparison with those of the Clinical and Laboratory Standards Institute (CLSI) means that the criteria for interpreting the susceptibility of some antimicrobials have been modified, resulting in changes in the reports of accumulated antibiotic susceptibility.Methods
The effect of applying EUCAST breakpoints in 10,359 clinical isolates of Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Staphylococcus aureus and Enterococcus spp. was analysed.Results
By applying EUCAST breakpoints, most antimicrobial susceptibility percentages did not change or changed very slightly. However, a decrease in aminoglycoside susceptibility was observed in Gram-negative bacilli, mainly for amikacin and Pseudomonas aeruginosa (23.2%), although only 5.7% were completely resistant; a notably decrease in the percentage of isolates susceptible to aztreonam was also observed. There was also a marked increase in the number of Staphylococcus aureus strains resistant to clindamycin (51.5%) and aminoglycosides (gentamicin 43.1%).Conclusions
Switching from CLSI to EUCAST criteria in some pathogens alters the percentages of resistance to several antimicrobials, and therefore the local epidemiology of the resistance. These changes should be implemented by a multidisciplinary group in order to analyse the influence of the new data on the empirical treatment protocols of each centre. 相似文献14.
Ivan Sanz Muñoz Silvia Rojo Rello Raúl Ortiz de Lejarazu 《Enfermedades infecciosas y microbiología clínica》2018,36(9):572-575
Introduction
The aim of this study was to analyze the presence of antibodies against both Yamagata and Victoria influenza B lineages and to check the response after seasonal trivalent vaccination.Materials and methods
Haemagglutination inhibition assays were performed with pre-and post-vaccination serum samples from 174 individuals ≥65 years of age vaccinated with seasonal trivalent influenza vaccines during the 2006–2007, 2008–2009, 2009–2010 and 2010–2011 vaccine campaigns.Results
33.9% of individuals showed pre-vaccine protective antibodies (≥1/40) against B/Yamagata lineage and 41.4% against B/Victoria lineage. The annual trivalent vaccine induced significant homologous seroconversion in 14–35.6% of individuals in each vaccine campaign.Conclusions
The population ≥65 years has low-moderate seroprotection against B influenza lineages. Trivalent vaccination induced a slight increase of seroprotection. The trivalent vaccine should be administered to all individuals ≥65 years in all vaccine campaigns. 相似文献15.
Laura Palau Dávila Elvira Garza-González Patricia Rodríguez-Zulueta Rayo Morfín-Otero Eduardo Rodríguez-Noriega Diana Vilar-Compte Juan C. Rodríguez-Aldama Adrián Camacho-Ortiz 《The Brazilian journal of infectious diseases》2017,21(5):530-534
Introduction
The epidemiology of Clostridium difficile infection (CDI) has changed in the last two decades. There is a lack of information regarding incidence and severity of CDI, especially in the developing world.Methods
This was a retrospective and observational study from four hospitals of three Mexican cities. Patients were diagnosed with CDI when presented with loose stools and had at least one of the following tests positive: toxins assay, real-time PCR, or an endoscopic image compatible with pseudomembranous colitis. CDI was classified according to international guidelines. Demographic and clinical data as well as information regarding total hospital admissions, total length-of-hospital stay, and other variables related to hospitalization were gathered from the epidemiology and administration departments of each hospital.Results
A total of 2050 hospital beds were analyzed with 288,171 patients hospitalized accumulating 1,576,446 days of hospitalization during the study period. The average rate of CDI per 1000 hospital-days was lower than the rates reported in the US and Europe, although in 2015 CDI rates were almost persistently above the mean rate for the study period. More than half of PCR positive patients were ribotype 027.Conclusion
Hospital rates of CDI are increasing in Mexican hospitals with a predominance of infections caused by ribotype 027. 相似文献16.
Sabina Herrera Luisa Sorlí Maria Jose Pérez-Sáez Patricia Ruiz-Garbajosa Clara Barrios Virginia Plasencia Milagro Montero Roser Terradas Marta Crespo Xavier Castells Rafael Cantón Julio Pascual Juan Pablo Horcajada 《Enfermedades infecciosas y microbiología clínica》2017,35(1):5-11
Objective
To describe a clonal outbreak due to vancomycin-resistant Enterococcus faecium (VREF) in the nephrology and renal transplant unit of a tertiary teaching hospital in Barcelona, Spain, and to highlight how active patient and environment surveillance cultures, as well as prompt and directed intervention strategies, mainly environmental, helped to successfully bring it under control.Patients and methods
A study was conducted on patients admitted to the nephrology ward with any culture positive for VREF over a 6-month period (August 2012–January 2013). Based on the identification of a clonal link between the isolates, weekly rectal screening using swabs was implemented for all patients, as well as environmental cultures and cleaning of medical equipment and the ward. VREF isolates were identified by MicroScan and confirmed by Etest. Bacterial identification was confirmed by MALDI-TOF MS. The presence of van genes, and esp and hyl virulence genes was determined using PCR. The clonal relationship between the isolates was studied first with DiversiLab (bioMérieux), and then by PFGE-Smal and MLST. A two-tier sequence of infection control measures was implemented.Results
During the study period, VREF was isolated from 13 patients. All cases were colonized with no criteria for infection. VREF isolates were also extensively recovered from the environment and medical equipment. Isolates carried the vanA gene, and were multidrug-resistant, including high-level resistance (MIC >16 mg/L) to vancomycin and teicoplanin. Molecular analysis showed that all VREF isolates belonged to sequence type 17 (ST17) carrying hyl virulence genes. After implementing infection control measures in a two-tier sequence, and reinforcing particularly environmental and medical equipment cleaning, no further cases were detected in the follow-up year.Conclusion
A clonal outbreak of VREF-ST17 involving only colonization is reported. The prompt implementation of aggressive infection control measures in patients and the environment was effective in controlling the outbreak and avoided the potential emergence of infection among patients. 相似文献17.
S. Zoghi V. Ziaee T. Hirschmugl R. Jimenez-Heredia A. Krolo K. Boztug N. Rezaei 《Allergologia et immunopathologia》2018,46(6):594-598
Introduction and objectives
Pediatric Systemic Lupus Erythematosus (pSLE) is an autoimmune disorder of children. Early disease onset raises the probability of genetic etiology and it is more severe than adult SLE.Patients and methods
Herein an eight-year-old girl with pSLE from consanguineous parents is reported.Results
Although she was diagnosed as pSLE since the age of two years, Whole Exome Sequencing (WES) revealed a rare stop-gained C>T mutation in C1QA gene. The variant was validated and segregated in patient and the family. Furthermore, serum levels of the C1q protein were measured and found to be much lower than normal ranges.Conclusions
This study indicated that C1Q deficiency should be considered as a differential diagnosis of pSLE. Therefore, measurement of C1q should be recommended in all cases with pSLE. 相似文献18.
Jui-Cheng Chen Cheng-Chih Tsai Chang-Chi Hsieh Alice Lan Chun-Chih Huang Sew-Fen Leu 《Allergologia et immunopathologia》2018,46(4):354-360
Background
Probiotics could be beneficial to health and some of them have shown to modulate immune responses.Aim
The aim of this study is to investigate if the probiotic strains including Lactobacillus and Pediococcus strains are able to alleviate allergic reactions in an ovalbumin-induced airway allergy model.Methods
Lactobacillus multi-species preparation (LMP) was gavaged to BALB/c for total six weeks and BALB/c was challenged with ovalbumin in the last two weeks. A barometric whole-body plethysmography was used to assess enhanced pause (Penh) of airway hyperreactivity (AHR). Immunoglobulins (Ig) such as IgE, IgG1, IgG2a and cytokines such as IL-12, IFN-γ, IL-4, IL-5, TNF-α and IL-13 in bronchoalveolar lavage fluid were assayed using ELISA kits.Results
The results showed this LMP significantly reduced Th2 cytokines and enhanced Th1 cytokines production. OVA-specific IgE and IgG1 was lower in the probiotics-treated mice whereas IgG2a was increased. Most importantly, this murine model showed LMP supplementation significantly reduced AHR.Conclusions
Overall, this Lactobacillus multi-species preparation seemed to suppress OVA-sensitized airway hyperreactivity, thus serving as a possible candidate for therapeutic uses for allergic airway symptoms. 相似文献19.
Zaira Moure Ariadna Rando-Segura Laura Gimferrer Gloria Roig Tomas Pumarola Virginia Rodriguez-Garrido 《Enfermedades infecciosas y microbiología clínica》2018,36(5):293-295
Introduction
Campylobacter spp. infection is one of the leading causes of foodborne diarrhoeal illness in humans worldwide. The purpose of this study was to evaluate the DiaSorin LIAISON®Campylobacter assay for human campylobacteriosis diagnosis.Methodology
A total of 645 stool samples from 640 patients suspected of having gastrointestinal infection were included. A stool culture was simultaneously performed with the DiaSorin LIAISON®Campylobacter assay to detect the presence of Campylobacter spp.Results
Taking the conventional culture to be the perfect gold standard, sensitivity and specificity rates of the DiaSorin LIAISON®Campylobacter assay were 100% and 97.7%, respectively; and 99.1% and 98.6%, respectively, when taking the culture to be the imperfect gold standard (Bayesian Model).Conclusion
This new assay might be a useful tool especially for the screening of negative results. 相似文献20.