There is higher risk of BT in trauma patients, and it is associated with a significant increase of postoperative infections. An abdominal trauma index ≥10 was found to be associated with the development of BT. This is the first study describing BT among patients with abdominal trauma, where causality is confirmed at molecular level.
Presentación de Caso Reto clínico en el diagnóstico y tratamiento de leptospirosis Challenge in Clinical diagnosis and Treatment of Leptospirosis desafio clínico no diagnóstico e tratamento de leptospirose
ResumenLos microorganismos aislados con mayor frecuencia en pacientes con neumonía grave adquirida en la comunidad (NAC) son: Streptococcus pneumoniae, Legionella pneumophila y gérmenes Gram negativos. En Colombia no se han reportado casos de neumonía por Legionella ya que se requiere un medio de cultivo especial para su aislamiento. Con el fin de determinar el papel de este microorganismo como agente etiológico de la neumonía grave adquirida en la comunidad, se hizo un estudio descriptivo, sobre una población de 187 enfermos, quienes constituyen la totalidad de los casos de NAC que ingresaron al Hospital de San José, en la ciudad de Bogotá, Colombia, entre octubre de 1999 a junio de 2001 y de los cuales 20 representan los casos de NAC grave. En este estudio, la Legionella pneumophila no se aisló como agente etiológico de NAC grave, por lo tanto la indicación terapéutica de los macrólidos en nuestro medio, sospechando esta patología, debe ser reevaluada.Palabras claves: neumonía adquirida en la comunidad, Legionella pneumophila, enfermedad de los legionarios, macrólidos.
Background: The identification and molecular characterisation of bacteria associated with neonatal necrotising enterocolitis (NNE) and sepsis is very important in clarifying the role such bacteria play in the development of this disease. Methods: The present multicentre study was aimed at characterising bacteria isolated from haemocultures obtained from 20 neonates suffering NNE by using traditional and molecular methodologies (16 S rRNA subunit sequencing and multilocus sequence typing - MLST). Results: NNE incidence in hospitals in Bogotá was also estimated, finding rates similar to and higher than those reported in the literature (1 to 3 cases of NNE per 1,000 live-births). Staphylococcus epidermidis ST2, ST81, and ST126 sequence types were identified by using these two molecular techniques; the Escherichia coli ST394 sequence type was also identified. Species could not be identified for the Pantoea agglomerans isolate due to the high degree of intra-species identity. Interestingly, the bacterial isolates from the two neonates who died were classified in the same sequence type (i.e. S. epidermidis ST81), even though they came from different hospitals. Conclusion: Such molecular techniques allow characterising bacterial pathogen populations occurring in one or more hospitals in a particular city or determined geographical area and support taking more specific preventative measures directed against such particular clones. Key words: Necrotising enterocolitis (NNE), sepsis, molecular characterisation, multilocus sequence typing (MLST).
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