Acute paracoccidioidomycosis due to Paracoccidioides brasiliensis S1 mimicking hypereosinophilic syndrome with massive splenomegaly: diagnostic challenge

Submitted by Janaína Nascimento ([email protected]) on 2019-04-18T14:24:49Z No. of bitstreams: 1 ve_Macedo_Priscila_etal_a_INI_2016.pdf: 251553 bytes, checksum: ac4c0d04c5e3dc4428a8995d2b5f4457 (MD5)Approved for entry into archive by Janaína Nascimento ([email protected]) on 2019-04-22T14:14:30Z (GMT) No. of bitstreams: 1 ve_Macedo_Priscila_etal_a_INI_2016.pdf: 251553 bytes, checksum: ac4c0d04c5e3dc4428a8995d2b5f4457 (MD5)Made available in DSpace on 2019-04-22T14:14:30Z (GMT). No. of bitstreams: 1 ve_Macedo_Priscila_etal_a_INI_2016.pdf: 251553 bytes, checksum: ac4c0d04c5e3dc4428a8995d2b5f4457 (MD5) Previous issue date: 2016Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Dermatologia Infecciosa. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Micologia. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Dermatologia Infecciosa. Rio de Janeiro, RJ, Brasil.Central Hospital of Military Police. Nosocomial Infection Surveillance and Control Program. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Department of Inpatient Health Care. Rio de Janeiro, RJ Brasil.Universidade Federal do Rio de Janeiro. Department of Internal Medicine. Rio de Janeiro, RJ, Brazil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Micologia. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Micologia. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Dermatologia Infecciosa. Rio de Janeiro, RJ, Brasil

Occurrence of a Multidrug-Resistant Pseudomonas aeruginosa Clone in Different Hospitals in Rio de Janeiro, Brazil

Multidrug-resistant Pseudomonas aeruginosa nosocomial infections are increasingly recognized worldwide. The existence of metallo-β-lactamase- and extended-spectrum β-lactamase-producing isolates exhibiting resistance to most β-lactam antimicrobial agents greatly complicates the clinical management of patients infected with such isolates. Since 1998, P. aeruginosa isolates resistant to all commercially available antimicrobial agents have been detected at a university-affiliated public hospital in Rio de Janeiro, Brazil. The present study was designed to characterize the antimicrobial resistance profiles and the genetic diversity of the P. aeruginosa strains isolated at this hospital and four private hospitals in Rio de Janeiro. Between April 1999 and March 2000, 200 consecutive isolates were obtained and analyzed for antimicrobial resistance. The genetic diversity of a selected number of them was evaluated by pulsed-field gel electrophoresis and PCR with the ERIC-2 primer. A predominant genotype, designated genotype A, was identified among isolates from four of the five hospitals evaluated. Eighty-four ceftazidime-resistant isolates were evaluated for metallo-β-lactamase production, which was detected in 20 (91%) of 22 genotype A isolates and 11 (18%) of 62 isolates belonging to other genotypes (P < 0.05). Two metallo-β-lactamase-producing genotype A isolates also produced an extended-spectrum β-lactamase. The occurrence of multidrug-resistant P. aeruginosa strains belonging to a unique genotype in different hospitals in Rio de Janeiro underscores the importance of the contribution of a single clone to the increase in the incidence of multidrug-resistant P. aeruginosa nosocomial infections