Ciertos fármacos que son excretados en orina, como los antibióticos, pueden formar cristales cuando la dosis empleadas son elevadas, la diuresis se encuentra disminuida o el pH de la orina es ácido. Los eventos de cristaluria medicamentosa son poco frecuentes y pueden ser cuadros asintomáticos e incluso originar fallos renales agudos. En este reporte se describen dos casos: una mujer de 26 años con cristaluria de ampicilina y una niña de 8 años con cristaluria de amoxicilina, registrados en el laboratorio de urgencias del Hospital Central del Instituto de Previsión Social. El análisis del sedimento fue realizado empleando microscopía óptica, luego los cristales fueron sometidos a microscopía de polarización y espectrofotometría infrarroja logrando la identificación exacta de la naturaleza química de los cristales. Este es el primer reporte de cristaluria medicamentosa del país y pone de manifiesto la importancia del trabajo colaborativo entre instituciones del estado. Palabras clave: Cristaluria medicamentosa, FTIR, microscopía de polarización Drug induced crystalluria in the Emergency Laboratory: Report of two cases A B S T R A C TCertain drugs that are excreted in the urine, including antibiotics, could induce the formation of crystals when the dose used is high, the diuresis is low or the pH of the urine is acid. The events of drug induced crystalluria are rare and could be asymptomatic or could cause acute renal failure. In this report, we describe two cases: One of a 26-year-old woman with ampiciline crystalluria and a 8-year-old child with amoxiciline crystalluria, both registered at the Emergency Laboratory of the Central Hospital of the Instituto de Prevision Social. The analysis of the urinary sediment was made by conventional microscopy, and then the crystals were studied by polarized light microscopy and infrared spectroscopy achieving the exact identification of the chemical nature of the crystals. This is the first report of drug induced crystalluria in the country and shows the importance of the colaborative work between state institutions.
PurposeTo establish the conjunctival contamination source by coagulase-negative staphylococci (CNS) during cataract surgery and discuss the implications of this colonization as a potential risk of acquiring endophthalmitis.Methods Conjunctiva samples for culture from 59 patients undergoing cataract surgery were taken of the fellow eye at baseline (T1) and from the eye to be operated before (T0) and immediately after (T2) irrigation with povine-iodine IOP5%, and at the end of surgery (T3). Genes responsible for virulence (mecA, ica and atlE) and antibiotic profile were determined; strain clonality of persistent colonizing S. epidermidis strains was established by the Multi-locus sequence typing (MLST).Results The frequency of CNS was significantly reduced in T2 (13.6%) from 81.4% in T0 and 86.4% in T1. The frequency of mecA, ica and atlE genes was 35.9%, 41.7% and 67.2%, respectively; and methicillin phenotypic resistance was 35.4%. S. epidermidis was the most frequent species isolated in every time point. MLST revealed in 7 patients 100% coincidence of the 7 alleles of the S. epidermidis isolated previous to povine-iodine 5% disinfection and at the end of the surgery. CNS isolates from T2 or T3 corresponded to the same species, antibiotic and virulence profile as those isolates from T1 or T0.Conclusion Pre-surgical prophylactic scheme significantly reduced conjunctival contamination; in those that persisted, the source of contamination was mostly the patient's microbiota confirmed by the MLST system.
Este es un artículo publicado en acceso abierto bajo una Licencia Creative Commons
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.