Highly virulent clonotypes of serotype III seem to cause much of the perinatal morbidity and mortality attributed to Streptococcus agalactiae (group B streptococci, GBS), One of these clonal types, designated the "high-virulence clone" (HVC), was identified by its inability to grow at 40 degrees C in a chemically defined medium. In the present study, this inability to grow at high temperatures was used as a marker to identify HVC in a sample of 286 Mexican GBS isolates. Forty-three isolates (15%) were identified as belonging to this clone: 15 were invasive isolates, 33 were serotype III (77%), and 10 were of serotypes other than type III (23%). These results demonstrate that HVC is more prevalent in Mexico than previously reported and that this clone is not restricted to serotype III isolates.
Introducción: La desnutrición en el paciente crítico se relaciona con mal pronóstico. Las pérdidas proteicas se identifican de manera convencional mediante parámetros bioquímicos. La masa muscular puede reflejar la reserva corporal de proteínas, su medición por medio de sonografía ha evidenciado una fuerte correlación para detección de alteraciones. Objetivo: Determinar la correlación de la medición sonográfica de los músculos Recto Femoral (RF) y Vasto Intermedio (VI), con los parámetros bioquímicos convencionales de valoración nutricional. Métodos: Se estudiaron 12 pacientes mayores de 18 años, que recibieron dieta enteral temprana. Se midieron los parámetros bioquímicos, simultáneamente con parámetros sonográficos a nivel de RF y VI en los días uno y siete. Se estableció correlación entre los parámetros bioquímicos y sonográficos significativos. Resultados: El parámetro bioquímico con mayor significancia estadística fue el Balance Nitrogenado Urinario (BNU) en muestra de orina de 24 horas (p=0.001). En mediciones sonográficas, el porcentaje de reducción muscular para RF y VI mostró mayor diferencia (p=0.001). En análisis de correlación, se obtuvo fuerte correlación entre BNU y RF (r=0.77) así como BNU y VI (r=0.76). Conclusión: Existe correlación entre las pérdidas proteicas medidas por BNU y el porcentaje de reducción de los músculos RF y VI medidos por sonografía. Palabras clave: Sonografía muscular, parámetros bioquímicos de valoración nutricional. SUMMARY Introduction: Malnutrition in critically ill patients is associated with poor prognosis. Protein losses are identified conventionally by biochemical parameters. The muscle mass can reflect the body protein reserve, its measurement by means of sonography has shown a strong correlation for the detection of alterations. Objective: To determine the correlation of the sonographic measurement of the Rectus Femoris (RF) and Vastus Intermedius (VI) muscles, with the conventional biochemical parameters of nutritional assessment. Methods: We studied 12 patients older than 18 years who received an early enteral diet. The biochemical parameters were measured, simultaneously with sonographic parameters at the level of RF and VI on days one and seven. Correlation was established between the significant biochemical and sonographic parameters. Results: The biochemical parameter with the greatest statistical significance was the Urinary Nitrogen Balance (UNB) in a 24-hour urine sample (p = 0.001). In sonographic measurements, the percentage of muscle reduction for RF and VI showed greater difference (p = 0.001). In correlation analysis, strong correlation was obtained between UNB and RF (r = 0.77) as UNB and VI (r = 0.76). Conclusion: There is a correlation between the protein losses measured by UNB and the percentage reduction of RF and VI muscles measured by sonography.
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