Rev Argent Microbiol
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Rev Argent Microbiol · Jan 2011
Comparative Study[Bacterial etiology of nosocomial pneumonia and antimicrobial resistance in patients with and without antimicrobial treatment].
Nosocomial pneumonia (NP) is associated with high morbimortality, representing the second cause of nosocomial infection after urinary tract infection. The objective of this work was to become acquainted with the etiology of NP and to evaluate the antimicrobial resistance profile of the isolated microorganisms from adult patients with and without previous antimicrobial treatment admitted in the intensive care unit (ICU). From 2000 to 2005, 430 bronchoalveolar lavages from 430 adult patients diagnosed with pneumonia admitted in the ICU were analyzed. ⋯ The main agents in both groups of patients were: Acinetobacter spp. (37.9% vs 36.1%), Staphylococcus aureus (21.3% vs 26.6% ) and Pseudomonas aeruginosa (20.9% vs 17.7%), respectively (p > 0,05). The antimicrobial resistance in Acinetobacter spp., P. aeruginosa and S. aureus from previously treated patients was higher than that from patients without previous antimicrobial treatment (p < 0,05), except in the case of trimethoprim-sulfamethoxazole in S. aureus (p = 0,29). In conclusion, previous antimicrobial treatment did not modify the etiology of NP, but caused an increase in overall antimicrobial resistance and a lower percentage of positive cultures.
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A clinical case of a female patient with a black spot on the palm of her left hand is presented. The infection was due to a black fungus identified as Hortaea werneckii, the aetiological agent of tinea nigra palmaris. ⋯ In this case, the patient was treated with econazole locally applied during one month, with complete remission of the lesions. In conclusion, the early diagnosis of this disease is very important since the mycology procedures are fast and non-invasive and cure is obtained with local treatment.
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Rev Argent Microbiol · Jan 2006
[Clinical and microbiological study of mycetomas at the Muñiz hospital of Buenos Aires between 1989 and 2004].
This work presents clinical, microbiological and outcome data collected from 76 patients with mycetomas at the Muñiz Hospital from 1989 to 2004. Forty-nine patients were male and 27 female; the mean age was 43.4 years. The majority of the patients acquired the infection in Argentina: the most affected provinces were Santiago del Estero with 31 cases, and Chaco with 11; 8 cases came from other countries (Bolivia 6 and Paraguay 2). ⋯ The following etiological agents were identified: Madurella grisea 29 cases, Actinomadura madurae 26, Scedosporium apiospermum 5, Nocardia brasiliensis 5, Acremonium spp. 4 (Acremonium falciforme 2, Acremonium kiliense 1, Acremonium recifei 1), Madurella mycetomatis 3, Fusarium solani 2, Nocardia asteroides 1 and Streptomyces somaliensis 1. The main drugs used in the treatments were ketoconazole and itraconazole for maduromycotic mycetomas, and cotrimoxazole associated with ciprofloxacin or amikacin for actinomycetic mycetoma. Six patients had to undergo amputation, 25 cases achieved complete clinical remission and 34 showed remarkable improvement.
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Rev Argent Microbiol · Apr 2005
[Frequency of pulmonary and extrapulmonary tuberculosis in a reference hospital in Córdoba province, 1991-2003].
Tuberculosis continues to be a serious problem of public health causing nearly three million deaths per year all over the world. Despite technologic improvements in the diagnostic methods, it is not possible to control the disease in the absence of surveillance and treatment follow-up programs supervising the ending of treatments, and definitive cure of patients. The frequency of pulmonary and extrapulmonary tuberculosis, and simultaneous pulmonary and extrapulmonary tuberculosis localization among patients assisted at Tránsito Cáceres de Allende Hospital during thirteen years (1991-2003), was determined. ⋯ Out of the 723 pulmonary cases, 9 were caused by M. bovis. All M. bovis isolates grew on Stonebrink medium, and only one grew also on Lowenstein Jensen. Smear microscopy using Ziehl Neelsen staining resulted positive in 4 extrapulmonary specimens.
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Rev Argent Microbiol · Apr 2001
[Clostridium difficile diarrhea: frequency of detection in a medical center in Buenos Aires, Argentina].
Clostridium difficile has been recognized as the most important enteric pathogen of nosocomial antibiotic-associated diarrhea (CDAD) in adults from industrialized countries. The importance of C. difficile as a cause of diarrhea in ambulatory patients appears underestimated or under-recognized. Since the 1980's, outbreaks of CDAD have been increasingly reported, but there are few data available in Argentina. ⋯ The prevalence of CDAD in this study was less than in others previously reported. This difference may be due to the fact that not all general practitioners include testing for C. difficile when the patient with diarrhea had previously received antibiotics. More educational programs should be directed to all physicians, concerning the role of C. difficile as an important enteric pathogen in patients who have undergone treatment with antimicrobial or chemotherapeutic agents.