Las infecciones del tracto urinario está entre las enfermedades infecciosas más frecuentes y representan la primera causa de consulta médica en mujeres en edad reproductiva. Dentro de los factores de ...riesgo para el desarrollo de esta enfermedad se encuentran las relaciones sexuales, malos hábitos de micción, uso de espermicidas, estreñimiento, factores genéticos y disminución de estrógenos. En el diagnóstico la clínica siempre debe predominar, el examen general de orina y el urocultivo deben usarse de manera racional; existen biomarcadores como nuevos métodos para el diagnóstico que están siendo implementados. En cuanto al tratamiento distintos cuadros clínicos requieren distintas duraciones de terapia antimicrobiana, tanto el exceso de días como su falta deben evitarse. Se han investigado diversos métodos para prevenir las infecciones urinarias recurrentes como el uso de vacunas, cranberry, probióticos y terapia estrogénica.
Diagnóstico microbiológico de las infecciones urinarias de Toro-Peinado, Inmaculada; Concepción Mediavilla-Gradolph, M; Tormo-Palop, Nuria ...
Enfermedades infecciosas y microbiología clínica,
July 2015, Letnik:
33
Journal Article
Recenzirano
Resumen La infección del tracto urinario es la infección bacteriana más frecuente observada en el ámbito ambulatorio: 1 de cada 3 mujeres desarrollará una infección urinaria que requerirá tratamiento ...con antibióticos antes de los 24 años y, al menos, el 50% una infección del tracto urinario durante su vida. Además, las infecciones del tracto urinario representan el 40% de las infecciones nosocomiales, usualmente asociadas a sondajes urinarios. Aunque el cultivo de orina no estaría indicado en todos los casos, estas muestras son las más abundantes en los laboratorios de microbiología clínica, y la carga de trabajo que conllevan tiene una repercusión importante en el funcionamiento del laboratorio. Se trata fundamentalmente de orinas ambulatorias ”dección media”, de las cuales el 60-70% son cultivo negativo. En la actualidad existen sistemas comerciales disponibles con objeto de automatizar y simplificar su procesamiento. Clásicamente se han considerado positivas orinas con recuento ≥ 105 UFC/ml, aunque se valoran recuentos más bajos en determinadas situaciones clínicas. Factores relacionados con este recuento, como el modo de obtención de la orina, su conservación y el uso de conservantes químicos, así como el significado de estos bajos recuentos son puntos críticos que se analizarán detalladamente. El desarrollo de resistencias antimicrobianas afecta, lógicamente, a los uropatógenos, fundamentalmente Escherichia coli, que sigue siendo el más frecuentemente aislado. El objetivo de este texto es hacer una revisión de los aspectos más relevantes que influyen en el diagnóstico microbiológico de las infecciones del tracto urinario.
is a well-known opportunistic uropathogen that can occur with cystitis, pyelonephritis, and urinary sepsis. Although a wide variety of coryneform bacteria have been found from the male genital tract ...of prostatitis patients, only one clinical case of prostatitis caused by
has been reported. The aim of this study was to evaluate the
tropism of
towards LNCaP (lymph node carcinoma of the prostate) human cells line and the influence of acetohydroxamic acid as an irreversible urease inhibitor on different aspects of its pathogenicity by means of several
tests, such as the determination and analysis of growth curves, MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay, the production of biofilms, and adhesion to LNCaP and HeLa cell lines. Results have brought new pieces of evidence on the
tropism of
for the human prostate cell line LNCaP and the therapeutic use of the irreversible urease inhibitors such as acetohydroxamic acid (AHA), not only as enzyme blockers to facilitate the removal of encrustations but also as modulators of some pathogenic mechanisms. These interesting preliminary data allow us to assert that there is a real possibility that
is a new candidate for chronic idiopathic prostatitis.
The early treatment of urinary tract infections (UTIs) is directly related to decrease in morbidity, which makes the empirical treatment of great importance. Recently, beta lactamases of several ...types have emerged as significant mechanisms of resistance in Gram-negative bacilli, especially Escherichia coli. Our aim was to study the urinary E. coli isolated from Lebanese patients and to characterize their mechanisms of resistance. The study analyzed data between 2005 and 2012 of UTIs caused by E. coli. The mechanisms of resistance were characterized by phenotypic and genotypic methods and the pulsed-field gel electrophoresis (PFGE) was used to determine the different bacterial clusters. As expected, the highest incidence was observed with E. coli (60.53-73.98%) followed by K. pneumoniae (5.32-8.33%). ICU isolates were constantly associated with the lowest rates of susceptibility to extended-spectrum cephalosporins, ciprofloxacin, as well as most of the tested antibiotics. A 100% occurrence of CTX-M in extended-spectrum β-lactamase (ESBL)-producing isolates was recorded, followed by TEM, SHV, and OXA. In addition, 15.9% harbored 4 different ESBL enzymes and only 13 isolates (14.8%) harbored only one enzyme (CTX-M). Over the years, the simultaneous susceptibility of E. coli to ceftazidime and ciprofloxacin decreased from 62.5% in 2006 to 48.7% in 2012. PFGE results demonstrated that 10 clusters were 32 generated, denoting diversity among detected isolates. Understanding the epidemiology of resistance is 33 instrumental for the implementation of recommendations for the management of antimicrobials, infection 34 control measures, as well as active surveillance and antimicrobial stewardship.
Thrombosis can cause the occlusion of implantable medical devices, leading to the rejection of the device and subsequent mortality. Thrombosis is primarily induced by red blood aggregation and ...coagulation. The administration of anticoagulant drugs is generally used as a treatment to avoid these processes. Adverse effects such as bleeding in the event of an anticoagulant overdose, osteoporosis associated with prolonged use, hypersensitivity, and hives have been reported. New strategies such as biomolecule surface functionalization have recently been studied to overcome these problems. In this study, we report a novel coating composed of polydopamine (PDA) and proanthocyanidins (PACs) from blueberry extract to avoid red blood aggregation in short-term use medical devices such as silicone catheters. We showed that PDA formed stable films on silicone surfaces and PACs could be immobilized on PDA layers using laccase as a catalyst. The PDA–PACs films decreased surface hydrophilicity, increased surface roughness, and decreased plasma protein adsorption. The films were stable in phosphate buffer saline (PBS) and cell culture media. Furthermore, red blood cell adsorption and aggregation decreased. These effects are attributed to changes in the membrane fluidity that influences adhesion, the steric hindrance of the layers, and the low adsorption of plasma proteins on the PAC layer.
Quinolone and ß-lactam resistance mechanisms and clonal relationships were characterized among Escherichia coli isolates resistant to ciprofloxacin and extended-spectrum cephalosporins associated ...with human extra-intestinal infections in Rome. The E. coli. ST131 clone was found to be prevalent. This clone invariably carried a specific pattern of substitutions in the topoisomerase genes and all isolates but one produced CTX-M-15. One ST131 isolate produced SHV-12. The new ST131 variant described here is of particular concern because it combines fluoroquinolone resistance and chromosomally encoded CTX-M-15.
Background & Objective: Urinary infection is one of the most prevalent infectious diseases, and Escherichia coli is the most important cause of urinary infections. This study was done with the aim of ...surveying the amount of susceptibility and resistance among the strains of Escherichia coli isolated from those who referred to the private laboratories in the Iranian city of Tabriz. Materials & Methods: This survey was done periodically during the first 6 months of the year 2010. Samples were obtained in a sterile manner and were subjected to all necessary pathological tests. Evaluation of antibiotic susceptibility was conducted with disk diffusion standard method, and the results were analyzed. Results: Totally, 5701 Escherichia coli strains were identified. The highest sensitivity to Imipenem was 90.95%, Nitrofurantoin 85.97%, and Cefotaxime 71.02% and the highest resistance to Ampicillin was 83.95%, Tetracycline 80.97%, and Co-trimoxazole 63.92%. Conclusion: Our results suggest that the cause of the high resistance of Escherichia coli strains to Ampicillin and Tetracycline could be the consumption of these antibiotics. Therefore, abstaining from overuse of unnecessary antibiotics and production of new-generation and cost-effective antibiotics are recommend.
Background: A lot of children suffer from urinary infections which can lead to pyelonephritis and cystitis. The main cause of these infections is uropathogenic strains of Escherichia coli. ...Serogroups and virulence factors of this bacterium play an important role in occurrence of infection’s symptoms. Unfortunately, due to the occurrence of antibiotic resistances, common treatments are ineffective and costly. The aim of this study was to study the distribution of virulence factors, serogroups and antibiotic resistance properties of uropathogenic Escherichia coli isolated from pediatrics with pyelonephritis and cystitis. Material and Methods: In this study which was conducted during the year 2012 to 2013, 121 Escherichia coli strains were isolated from boys (51 samples) and girls (70 samples) with pyelonephritis and cystitis impatient in Baqiat-alah Hospital, Tehran. Antibiotic resistance of the isolates against commonly used antibiotics in the cases of urinary infections was investigated using disk diffusion method. Finally, PCR reactions using specific primers were done in order to detect virulence factors, serogroups and antibiotic resistance genes. Results: Totally, 45.09% of boys and 55.71% of girls were positive for presence of uropathogenic Escherichia coli. The highest distribution of bacterium was seen in less than one year old boys (71.42%) and 5-12 years old girls (75%). Results showed that the distribution of Escherichia coli in children with pyelonephritis and cystitis were 55.55% and 44.89%, respectively. The most commonly detected serogroups in children with pyelonephritis were O1, O2, O4 and O7 while, the most commonly detected serogroups in children with cystitis were O1, O2, O6 and O16. The most frequent virulence factors in the cases of pyelonephritis were pap (100%), afa (97.5%), sfa (95%), hly (95%) and cnf-1 (92.5%) and their most frequent in the cases of cystitis were fim (100%), pap (72.7%), afa (63.6%) and hly (45.4%). The genes which encode antibiotic resistance against gentamicin (aac(3)-IV) (96.7%), beta-lactams (blaSHV and CITM) (90.3% and 88.7%, respectively), tetracycline (tetA) (82.2%), had the highest incidence in the bacterial isolates. Escherichia coli isolates had the highest antibiotic resistance against gentamicin (95.1%), ampicillin (91.9%), amikacin (85.4%) and ciprofloxacin (83.8%). Discussion: Determination of the antibiotic resistance pattern in uropathogenic Escherichia coli isolated from children with urinary infections is important in each area or in hospital. Imipenem, due to its low antibiotic resistance, can be an effective drug for treatments of children with pyelonephritis and cystitis.
Objetivo: Avaliar a incidência e os fatores associados à infecção do trato urinário associados ao Cateter Vesical em adultos internados em clínica médica, bem como identificar a taxa de utilização, ...frequência do registro do pedido de inserção e retirada, adequação do uso em termos da indicação e do tempo de permanência do Cateter Vesical. Método: Trata-se de uma coorte prospectiva desenvolvida em um hospital universitário de Minas Gerais. Análises univariadas foram realizadas através do teste Qui-quadrado ou teste exato de Fisher para variáveis categóricas e teste não paramétrico de Mann-Whitney para variáveis numéricas. Resultados: Durante dez meses foram internados um total de 1.121 pacientes, desses, 63 (5,6%) fizeram o uso do Cateter Vesical, correspondendo a 880 Cateter Vesical/dia. A incidência de Infecção do Trato Urinário associada ao Cateter Vesical foi de 31,7%. Os resultados identificaram associações positivas entre ocorrência de infecção do trato urinário com o tempo de permanência hospitalar e tempo de uso do Cateter Vesical. Conclusão: A conduta frente à indicação de uso do Cateter Vesical deve ser criteriosa, desde a avaliação da recomendação, inserção, manutenção e a sua retirada o mais brevemente possível, garantindo a segurança do paciente. === Objective: The aim of this study was to evaluate the incidence and the factors related to catheter-associated urinary tract infection in adults who were hospitalized in the internal medicine service, and to identify catheter utilization rates, frequency of the register of order of insertion and removal, adequacy of use in terms of indication, and catheter vesical length of permanence. Method: This is a prospective cohort study conducted at a university hospital in Minas Gerais. Univariate analyses were performed using the chi-squared test or Fisher’s exact test for categorical variables, and the non-parametric Mann-Whitney test for numerical variables. Results: In ten months, 1121 patients were admitted, 63 (5.6%) of these used the vesical catheter, being 880 urinary catheters/day. The incidence of catheter-associated urinary tract infection was 31.7%. The results showed positive associations between the occurrence of urinary tract infection with the length of permanence and time of use of the vesical catheter. Conclusion: The use of urinary catheters should be limited to carefully selected patients, followed by a safe insertion and maintenance, and removed promptly, when no longer required, in order to ensure patients’ safety.
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