Navegando por Palavras-chave "Microbial drug resistance"
Agora exibindo 1 - 3 de 3
Resultados por página
Opções de Ordenação
- ItemAcesso aberto (Open Access)Alterações da microbiota conjuntival e palpebral após uso tópico de lomefloxacina e tobramicina na cirurgia de catarata e cirurgia refrativa(Conselho Brasileiro de Oftalmologia, 2002-01-01) Hofling-Lima, Ana Luisa [UNIFESP]; Farah, Michel Eid [UNIFESP]; Montenegro, Luciano [UNIFESP]; Alvarenga, Lênio Souza; Chalita, Maria Regina Catai; You, Maria Cecília Zorat [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Purpose: To determine the changes in the conjunctival and palpebral flora after topical use of 0.3% lomefloxacin and 0.3% tobramycin eye drops in the preoperative management of patients submitted to cataract and refractive surgery and to assess the chemosensitivity of bacterial isolates from the conjunctiva and eyelid to these antibiotics. Methods: A prospective study of the conjunctival and palpebral flora of patients submitted to cataract or to refractive (PRK or LASIK) surgery was performed. An analysis of the conjunctival and palpebral flora was carried out in patients before surgery without prophylaxis, after surgery during the use of prophylaxis (0.3% lomefloxacin or 0.3% tobramycin qid) and after discontinuation of the antibiotic. Results: Tobramycin and lomefloxacin reduced the number of positive cultures in specimens from the conjunctiva and eyelid of individuals submitted to cataract and refractive surgery. In both groups, isolated microorganisms displayed a greater resistance to tobramycin. In the group submitted to cataract surgery, patients treated with prophylactic tobramycin showed a slower recovery of the flora after discontinuation of the antibiotic than those treated with lomefloxacin, with the opposite occurring in the group submitted to refractive surgery. Conclusion: Both lomefloxacin and tobramycin were effective in reducing conjunctival and palpebral flora during drug administration. This reduction was more marked in the conjunctiva. Among the various bacterial isolates, there was a greater resistance to tobramycin than to lomefloxacin. The use of antibiotics reduced the incidence of positive cultures more for the conjunctiva than the eyelids.
- ItemAcesso aberto (Open Access)Como evitar o uso inadequado de antibióticos nas infecções de vias aéreas superiores? Posição de um painel de especialistas(Assoc Brasileira Otorrinolaringologia & Cirurgia Cervicofacial, 2018) Piltcher, Otavio Bejzman; Kosugi, Eduardo Macoto [UNIFESP]; Sakano, Eulalia; Mion, Olavo; Testa, Jose Ricardo Gurgel [UNIFESP]; Romano, Fabrizio Ricci; Santos, Marco Cesar Jorge; Di Francesco, Renata Cantisani; Mitre, Edson Ibrahim; Bezerra, Thiago Freire Pinto; Roithmann, Renato; Padua, Francini Greco; Valera, Fabiana Cardoso Pereira; Lubianca Neto, Jose Faibes; Sa, Leonardo Conrado Barbosa; Pignatari, Shirley Shizue Nagata [UNIFESP]; Avelino, Melissa Ameloti Gomes; Caixeta, Juliana Alves de Souza; Anselmo-Lima, Wilma Terezinha; Tamashiro, EdwinIntroduction: Bacterial resistance burden has increased in the past years, mainly due to inappropriate antibiotic use. Recently it has become an urgent public health concern due to its impact on the prolongation of hospitalization, an increase of total cost of treatment and mortality associated with infectious disease. Almost half of the antimicrobial prescriptions in outpatient care visits are prescribed for acute upper respiratory infections, especially rhinosinusitis, otitis media, and pharyngotonsillitis. In this context, otorhinolaryngologists play an important role in orienting patients and non-specialists in the utilization of antibiotics rationally and properly in these infections. Objectives: To review the most recent recommendations and guidelines for the use of antibiotics in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, adapted to our national reality. Methods: A literature review on PubMed database including the medical management in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, followed by a discussion with a panel of specialists. Results: Antibiotics must be judiciously prescribed in uncomplicated acute upper respiratory tract infections. The severity of clinical presentation and the potential risks for evolution to suppurative and non-suppurative complications must be taken into 'consideration'. Conclusions: Periodic revisions on guidelines and recommendations for treatment of the main acute infections are necessary to orient rationale and appropriate use of antibiotics. Continuous medical education and changes in physicians' and patients' behavior are required to modify the paradigm that all upper respiratory infection needs antibiotic therapy, minimizing the consequences of its inadequate and inappropriate use. (C) 2018 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda. This is an open access article under the CC BY license.
- ItemAcesso aberto (Open Access)Perfil de sensibilidade a antimicrobianos de bactérias isoladas do trato respiratório baixo de pacientes com pneumonia internados em hospitais brasileiros: resultados do Programa SENTRY, 1997 e 1998(Sociedade Brasileira de Pneumologia e Tisiologia, 2001-03-01) Sader, Helio Silva [UNIFESP]; Mendes, Rodrigo Elisandro [UNIFESP]; Gales, Ana Cristina [UNIFESP]; Jones, Ronald N.; Pfaller, Michael A.; Zoccoli, Cassia; Sampaio, Jorge; Universidade Federal de São Paulo (UNIFESP); Universidade de Iowa Faculdade de Medicina Departmento de Patologia; Laboratório Santa Luzia; Laboratório LâminaBackground: Nosocomial pneumonia is the most common fatal nosocomial infection with attributable mortality rates ranging from 30 to 60% and a rapid initiation of optimal antimicrobial therapy is important to obtain treatment success. SENTRY is a comprehensive antimicrobial surveillance study involving a great number of medical centers distributed worldwide. Objective: To evaluate the antimicrobial susceptibility of bacterial isolates collected from the lower respiratory tract of inpatients with pneumonia. Material & methods: The authors report the antimicrobial susceptibility of 525 isolates collected in 11 Brazilian hospitals, as part of the SENTRY program. The isolates were tested for susceptibility by broth micro-dilution against a large number of drugs. Results: The five most frequently isolated species were (n/%): Pseudomonas aeruginosa (158/30.1%), Staphylococcus aureus (103/19.6%), Acinetobacter spp. (68/13.0%), Klebsiella spp. (50/9.5%), and Enterobacter spp. (44/8.4%). These five species represented more than 80% of all isolates. P. aeruginosa demonstrated high rates of resistance to most antimicrobial agents tested. The highest susceptibility rates were shown by piperacillin/tazobactam (71.5%) and meropenem (69.0%). Acinetobacter spp. also showed very high rates of resistance. The most active compounds against this species were imipenem and meropenem (80.9% susceptibility) followed by tetracycline (63.2% susceptibility). Cephalosporin susceptibilities among Klebsiella spp were very low and 36.0% of isolates were considered ESBL producers based on increased MICs, > 2 mug/mL) to ceftriaxone or ceftazidime or aztreonam. Ceftriaxone was active against only 56.8% of Enterobacter spp. isolates (MIC50 1 mug/mL), while cefepime was active against 88.6% of these isolates (MIC, < 0.12 mg/mL). Oxacillin-resistance was detected in 43.7% of S. aureus isolates. The most active drugs against this species were vancomycin, teicoplanin, quinupristin/dalfopristin, and linezolid. Conclusion: The results of this study demonstrated a higher prevalence of Acinetobacter spp. and higher resistance rates among Gram-negative rods when compared with results from North American and European studies.