Analysis of the clinical significance of CoNS isolated from hemocultures and the precise detection of oxacillin resistance represent decisive factors for the correct choice of antibiotic therapy. Although vancomycin constitutes the normal treatment in most Brazilian hospitals, reduction in its use is recommended.
The Streptococcus agalactiae colonization prevalence and its susceptibility to antimicrobials in pregnant women at University Hospital of Santa Maria (HUSM) were evaluated from June to December 2009. The vaginal-rectal material was inoculated into tubes containing Todd-Hewitt broth with subsequent subculture on blood agar. The GBS identification was made through presumptive tests, confirmed by serological test and its susceptibility was evaluated. The occurrence ofGBS maternal-fetal transmission in the colonized pregnant women was researched. The GBS colonization was 11.11%. All strains were susceptible to penicillin, ampicillin, and vancomycin. Two strains (50%) were intermediate to clindamycin and one (25%) intermediate to erythromycin. A newborn whose mother was colonized had early-onset neonatal infection by GBS. By this, it is very important the research about the colonization by GBS in all pregnant women from 35 to 37 weeks of gestation and the use of intrapartum antibiotic prophylaxis for colonized pregnant women.Descriptors: Streptococcus agalactiae; Prevalence; Pregnant women; Newborns; Microbial Sensitivity Tests.
RESUMOAvaliou-se a prevalência de colonização pelo Streptococcus agalactiae e o seu perfil de sensibilidade frente aos antimicrobianos em gestantes no Hospital Universitário de Santa Maria (HUSM), de junho a dezembro de 2009. O material vaginal-retal foi inoculado em tubos contendo caldo Todd-Hewitt com posterior subcultura em ágar sangue. A identificação do EGB foi realizada através de testes presuntivos, confirmadas por teste sorológico e avaliado seu perfil de sensibilidade. Pesquisou-se ocorrência de transmissão materno-fetal do EGB nas gestantes colonizadas. A prevalência de colonização foi de 11,11%. Todas as cepas foram sensíveis à penicilina, ampicilina e vancomicina. Duas cepas (50%) foram intermediárias à clindamicina e uma (25%) intermediária à eritromicina. Um recém-nascido de mãe colonizada teve infecção neonatal de início precoce por EGB. Confirma-se a importância da pesquisa de colonização por EGB em todas as gestantes entre 35ª e 37ª semana de gestação e uso de quimioprofilaxia intraparto nas gestantes colonizadas.
The objective ofthis study was to characterize the prevalence and susceptibility profile ofStaphylococcus aureus isolates at University Hospital ofSanta Maria, through data collection at the Laboratory ofClinical Analysis, during April to June 2009. Were requested 3270 cultures and 1123 (34%) were positive. The prevalence of S. aureus in relation to positive cultures was 89 (7,93%). It was found that these strains, 33% were resistant to oxacillin and 34.45% showed resistance related erm gene. High sensitivity to trimethoprim-sulfamethoxazole (72/80%) was detected for the automation and no strain showed resistance to vancomycin. Therefore, the prevalence of S. aureus and oxacillin resistance at HUSM were lower than observed in other tertiary hospitals in Brazil.
As infecções hospitalares, especialmente as infecções de sítio cirúrgico (ISC), representam um sério problema de saúde pública, gerando maiores custos devido ao tempo de internação e à necessidade de tratamento com antimicrobianos.Neste estudo, foram analisadas 79 culturas de secreção de pele, sendo 23 culturas polimicrobianas e 56 monomicrobianas. O microrganismo mais isolado foi o Staphylococcus aureus (26 de 79 - 32,9%), seguido de Pseudomonas aeruginosa (21 de 79 - 26,6%) e Escherichia coli (13 de 79 - 16,4%). O espécime clínico prevalente foi secreção de ferida operatória (25 de 79 - 31,7%) e a unidade cirúrgica obteve o maior percentual de isolamentos (30 de 79 - 38%). Em relação aos perfis de sensibilidade antimicrobiana, 11 (84,6%) E. coli foram sensíveis à cefazolina e 22 (84,6%) S. aureussensíveis ao sulfametoxazol-trimetoprima. Para P. aeruginosa houve 20 (95,2%) de sensibilidade à tobramicina, constituindo uma alternativa para as ISC ocasionadas pela espécie.
Spontaneous bacterial peritonitis (SBP) is a frequent and severe complication that occurs in patient with cirrhosis and ascites. It occurs in 10% to 30% of patients admitted to hospital. The organisms that cause SBP are predominantly enteric. Escherichia coli is the most frequent recovered pathogen, and Gram-positive bacteria, mainly Staphylococcus spp., are being considered an emerging causative agent of SBP. Streptococcus bovis that may be found as part of the commensal bowel fl ora in about 10% of healthy adults constitute an uncommon cause of peritonitis that was fi rst reported in 1994. We describe the fi rst case of SBP at the University Hospital of Santa Maria (HUSM) caused by S. bovis, resistant to the antibiotics erythromycin and clindamycin (inducible clindamycin resistance detected by disk diffusion test using the D-zone test).
Spontaneous bacterial peritonitis (SBP) is a frequent and severe complication that occurs in patient with cirrhosis and ascites. It occurs in 10% to 30% of patients admitted to hospital. The organisms that cause SBP are predominantly enteric. Escherichia coli is the most frequent recovered pathogen, and Gram-positive bacteria, mainly Staphylococcus spp., are being considered an emerging causative agent of SBP. Streptococcus bovis that may be found as part of the commensal bowel flora in about 10% of healthy adults constitute an uncommon cause of peritonitis that was first reported in 1994. We describe the first case of SBP at the University Hospital of Santa Maria (HUSM) caused by S. bovis, resistant to the antibiotics erythromycin and clindamycin (inducible clindamycin resistance detected by disk diffusion test using the D-zone test).
Os estafilococos coagulase negativa (ECN) têm sua patogenicidade cada vez mais reconhecida. Além das infecções relacionadas aos dispositivos implantados, participam como agentes etiológicos em diversas infecções. A emergência de cepas resistentes à meticilina/oxacilina reduz as opções terapêuticas, pois são resistentes a todos os â-lactâmicos e às combinações de â-lactâmicos/inibidores de â-lactamase. Nesse contexto, diversos métodos têm sido empregados para a detecção da resistência à meticilina/oxacilina em ECN. No presente estudo avaliou-se 50 isolados de ECN resistentes à oxacilina. Staphylococcus epidermidis foi a espécie mais isolada 30 (60%), sendo o sangue o espécime clínico prevalente 19(38%) e a pediatria a unidade com o maior percentual de isolamentos 14 (28%). Estas cepas apresentaram elevado perfil de resistência sendo que 62% delas mostraram-se sensíveis apenas à vancomicina, teicoplanina e tigeciclina. O método “screening” com ágar oxacilina detectou a resistência em todos isolados. Os discos de oxacilina 1 ìg e cefoxitina 30 ìg não detectaram somente em dois isolados cada. Palavras-chave: estafilococos coagulase negativa; resistência oxacilina/meticilina; detecção de resistência
Introduction: Metallo-β-lactamase (MBL) has been reported all over the world. Methods: The inhibitory effect of mercaptopropionic acid (MPA) on bacterial growth was evaluated by comparison between disk diffusion and broth dilution methodology with determination of the minimum inhibitory concentration (MIC) for multidrug-resistant Acinetobacter baumanni strains. Results: MPA significantly inhibited growth of the strains. Conclusions: The use of MPA can affect the results in phenotypic methods of MBL detection.
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