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Medell M.,Hermanos Ameijeiras Hospital | Hart M.,Hermanos Ameijeiras Hospital | Marrero O.,Intensive Cares Unit | Espinosa F.,Hermanos Ameijeiras Hospital | And 2 more authors.
Brazilian Journal of Infectious Diseases | Year: 2012

Objective: To characterize mechanical ventilation-associated pneumonia (MVAP). Method: This is an observational descriptive study to characterize MVAP in 61 ventilated patients admitted in the intensive care units of the Hermanos Ameijeiras hospital during 2011. This study also aimed to isolate the bacteria causing MVAP and characterize their resistance to antibiotics. Results: 51 (83.60%) patients presented pulmonary infiltrates and 35 (50.81%) presented a clinical score ≥ 6 according to the Clinical Pulmonary Infection Score. Acinetobacter baumannii and Pseudomonas aeruginosa were the most frequently isolated microorganisms from patients with MVAP. Both microorganisms showed a high resistance to antibiotics. Carbapenems were the most frequent used antimicrobial therapeutic agents; elective antibiotic combinations were directed against both bacterial wall structure and nucleic acid synthesis. Conclusion: Patients with MVAP identified during the studied period showed similar frequency to those reported in medical literature. Thus, this study corroborated that this is still a relevant medical problem in this hospital. Acinetobacter baumannii and Pseudomonas aeruginosa were the most frequently isolated microorganisms from patients with MVAP. Antimicrobial treatment, empirical or not, are still the main risk factors for the development of multidrug-resistant strains of bacteria. The rate of resistance to antibiotics of Acinetobacter baumannii and Pseudomonas aeruginosa strains isolated from patients with MVAP was higher than those isolated from infected patients without MAVP. Tigecycline and colistin were the only antibiotics fully effective against Acinetobacter baumannii strains isolated in 2011 from patients with MVAP; against Pseudomonas aeruginosa strains, only colistin was fully effective. © 2012 Elsevier Editora Ltda. Source

Medell M.,Hermanos Ameijeiras Hospital | Martinez A.,Pediatric Hospital Juan Manuel Marquez | Valdes R.,Genetic Engineering and Biotechnology Center
Brazilian Journal of Infectious Diseases | Year: 2012

Objective: Thisobservational study described the characterization of bacteria isolated from the lower respiratory tract of ventilated patients hospitalized in intensive care units. The demonstration of isolated microorganism resistance to antibiotics and a time-trend analysis of infection comparing a 48-month period were also other objectives. Method: Semi-quantitative assays of 1254 samples taken from 741 ventilated patients were performed, while pathogens were identified using the Enterotube II assay and VITEK 2 Compact equipment. Bacterial resistance to antibiotics was assessed by the Kirby-Bauer disc diffusion method and time-trend analysis of infection was based on data recorded by hospital microbiology laboratories. Results: The most prevalent isolated bacteria from the patient's lower respiratory tract were with Gram-negative bacteria (67.8%) mostly represented by: Acinetobacter spp. (25.2%), Pseudomonas spp. (18.3%) and Klebsiellas spp. (9.4%). Acinetobacter spp. showed moderate high to very high resistance to ceftriaxone (CRO), gentamicin (CN), amikacin (AK), meropenem (MRP), aztreonam (ATM) and piperacillin/tazobactam (TZP). Some isolates of Acinetobacter spp. resistant to colistin (CS) were identified in this patient population. Pseudomonas spp. and Klebsiella spp. were very highly resistant to ampicillin/sublactam (AMS) and with moderate or low resistance to CRO, ATM, MRP, AK, CN and TZP. A decrease in the Pseudomonas spp. prevalence rate was observed, whereas an increase in Acinetobacter spp. and Klebsiella spp. prevalence rates were observed in a 48-month period. Conclusion: This research corroborated that these nosocomial infections are a relevant medical problem in our context. The most prevalent bacterial infections in the lower respiratory tract of ventilated patients were by Acinetobacter spp., Pseudomonas spp. and Klebsiella spp. The panel of antibiotics used as preventive therapy was not the solution of infections and probably induced drug-resistance mechanisms in these isolated microorganisms. © 2012 Elsevier Editora Ltda. Source

Acosta Medina E.,University of Habana | Delgado Roche L.,University of Habana | de los Becquer M.A.,University of Habana | Falcon Cama V.,Genetic Engineering and Biotechnology Center | And 2 more authors.
Acta Microscopica | Year: 2012

Atherosclerosis is a disease of the vascular wall that leads to myocardial infarction, stroke, ischemia, gangrene and aneurysm. The primary lesion of atherosclerosis is an elevated focal plaque within the intima, with a central lipid core (mainly cholesterol and cholesterol esters) and a fibrous layer that covers it. The aim of this study was the histopathological and ultrastructural characterization of the atherosclerotic lesions induced in rabbits by the administration of Lipofundin 20%, a rich-lipid emulsion. Nineteen New Zealand rabbits were distributed in two groups. Group A (8 animals) only received intravenous injections of PBS and Group B (11 animals) received 2 mL / kg weight of Lipofundin 20% for 8 days. On day 9 animals were sacrificed and the aortic archs were isolated for histological and ultrastructural examination. In Group A, non-histopathology alterations were observed in the artery intima. However, all aorta samples from rabbits of Group B (treated with Lipofundin 20%) showed atherosclerotic lesions characterized by intima thickening, media-to-intima migration of vascular smooth muscle cells and an increased presence of proteoglycan and collagen fibers. In some samples the injured area was thicker than media layer. Ultrastructural analysis presence of large amounts of foam cells with lipid droplets at the intracellular level and abundant extracellular lipid droplets. These lesions were classified as Type III/ IV according to the classification of the Committee on Vascular Lesions of the American Heart Association. Source

Medell M.,Hermanos Ameijeiras Clinical Surgical Teaching Hospital HHA | Hart M.,Hermanos Ameijeiras Clinical Surgical Teaching Hospital HHA | Duquesne A.,Institute of Tropical Medicine | Espinosa F.,Hermanos Ameijeiras Clinical Surgical Teaching Hospital HHA | Valdes R.,Genetic Engineering and Biotechnology Center
MEDICC Review | Year: 2013

INTRODUCTION Nosocomial pneumonia associated with use of mechanical ventilators is one of the greatest challenges confronted by intensivists worldwide. The literature associates several bacteria with this type of infection; most common in intensive care units are Acinetobacter baumannii, Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus and some of the Enterobacteriaceae family. OBJECTIVES To identify the causal agents of nosocomial ventilatorassociated pneumonia in patients receiving mechanical ventilation in the intensive care units of Havana's Hermanos Ameijeiras Clinical-Surgical Teaching Hospital in 2011, and to characterize their antibiotic resistance. METHODS A cross-sectional descriptive study was conducted using hospital administrative data of quantitative cultures from positive tracheal aspirates for January through December, 2011. Records were analyzed from 77 intensive care unit patients who developed nosocomial ventilator-associated pneumonia. Variables examined were age and sex, and pathogens identified from culture of tracheal aspirate and related antibiotic susceptibility. RESULTS Species most frequently isolated were: Acinetobacter baumannii in 53 patients (68.8%), Pseudomonas aeruginosa in 34 patients (44.2%), other species of Pseudomonas in 15 patients (19.5%), and Serratia marcescens, Klebsiella pneumoniae, and Escherichia coli in 12 patients each (15.6%). Some patients presented more than one pathogen in concurrent or successive infections. Antimicrobial susceptibility testing found high percentages of resistance to antibiotics in all these pathogens. Least resistance was found to colistin. CONCLUSIONS The prevalence of antibiotic resistance in bacteria causing nosocomial ventilator-associated pneumonia is of concern. Colistin is the drug of choice among the antibiotics reviewed, but sensitivity to other antibiotics should be assessed to search for more appropriate broad-spectrum antibiotics for treating nosocomial ventilator-associated pneumonia. Our results also suggest the need to strengthen infection control efforts, particularly in intensive care units, and to reassess compliance with quality control procedures. Multidisciplinary research involving microbiologists, epidemiologists, internists and intensivists is needed to fully understand the etiological and resistance patterns observed. Source

Padilla S.,Genetic Engineering and Biotechnology Center | Alvarez T.,Genetic Engineering and Biotechnology Center | Ferro W.,Genetic Engineering and Biotechnology Center | Guevara Y.,Genetic Engineering and Biotechnology Center | And 9 more authors.
Chromatographia | Year: 2010

Several plant-derived antibody (plantibody) purification approaches have been assessed demonstrating high purification capacities, but low recoveries (<30%) and poor sorbent stability. Thus, application of sorbents with high recovery, low ligand leakage and stable under harsh sanitization conditions could improve the efficiency antibody purification from this source. This paper reports for the first time MAbsorbents assessments in plantibody purification from tobacco plants. In conclusion MAbsorbent A1P is not suitable for plantibody HB-01 purification, while MAbsorbent A2P demonstrated high recovery (37.54 ± 15.15%) in 25 purification cycles. As recommendation, we consider that other elution conditions should be assessed before restudy the stability of this sorbent. © 2010 Vieweg+Teubner Verlag | Springer Fachmedien Wiesbaden GmbH. Source

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