13 research outputs found
Actualización sobre la lactancia materna en los recién nacidos con errores innatos del metabolismo intermediario
Los errores innatos del metabolismo intermediario (EIMi) son un grupo de enfermedades monogénicas que afectan alguna vía del metabolismo de las proteínas, los hidratos de carbono o los lípidos; cuando no son tratados a tiempo, se asocian con una elevada morbimortalidad. A la fecha, la piedra angular del tratamiento de los EIMi ha sido la terapia nutricional, cuyo propósito es evitar la acumulación de metabolitos tóxicos al restringir los sustratos que están involucrados en la vía afectada. El manejo nutricional en lactantes incluye una fórmula metabólica sin los nutrimentos involucrados en el EIMi más el aporte de alimentación al seno materno o fórmula infantil. Por el perfil de aminoácidos, la proporción de ácidos grasos esenciales y la protección contra enfermedades, la leche materna resulta un alimento ideal para los pacientes con EIMi. El objetivo de esta revisión de la literatura sobre la lactancia materna en algunos EIMi es servir de guía para el personal de salud involucrado en la atención médica de estos pacientes. La lactancia materna puede ser llevada a cabo de forma exitosa en pacientes con EIMi siempre que exista un seguimiento estrecho y continuo, de preferencia en centros especializados. El profesional de la nutrición y el pediatra deben individualizar las recomendaciones para proporcionar una lactancia a libre demanda en conjunto con una fórmula metabólica o una lactancia materna cuantificada, y con ello lograr una adecuada evolución en estos pacientes
Comparison of Enterococcus faecium and Enterococcus faecalis Strains isolated from water and clinical samples: antimicrobial susceptibility and genetic relationships.
Enterococci are part of the normal intestinal flora in a large number of mammals, and these microbes are currently used as indicators of fecal contamination in water and food for human consumption. These organisms are considered one of the primary causes of nosocomial and environmental infections due to their ability to survive in the environment and to their intrinsic resistance to antimicrobials. The aims of this study were to determine the biochemical patterns and antimicrobial susceptibilities of Enterococcus faecalis and E. faecium isolates from clinical samples and from water (groundwater, water from the Xochimilco wetland, and treated water from the Mexico City Metropolitan Area) and to determine the genetic relationships among these isolates. A total of 121 enterococcus strains were studied; 31 and 90 strains were isolated from clinical samples and water (groundwater, water from the Xochimilco wetland, and water for agricultural irrigation), respectively. Identification to the species level was performed using a multiplex PCR assay, and antimicrobial profiles were obtained using a commercial kit. Twenty-eight strains were analyzed by pulsed-field gel electrophoresis (PFGE). E. faecium strains isolated from water showed an atypical biochemical pattern. The clinical isolates showed higher resistance to antibiotics than those from water. Both the enterococci isolated from humans, and those isolated from water showed high genetic diversity according to the PFGE analysis, although some strains seemed to be closely related. In conclusion, enterococci isolated from humans and water are genetically different. However, water represents a potential route of transmission to the community and a source of antimicrobial resistance genes that may be readily transmitted to other, different bacterial species
Electrophoretic PFGE patterns from <i>E. faecium</i> and <i>E. faecalis</i>.
<p>A) Agarose gel electrophoresis showing the <i>Sma</i>I digestion patterns of enterococci. B) Graphical representation of the banding patterns. Lane 1) <i>E. faecium</i> (blood); lane 2) <i>E. faecalis</i> (pleural fluid); lane 3) <i>E. faecalis</i> (urine); lane 4) <i>E. faecalis</i> (wound); lane 5) <i>E. faecalis</i> (wetland, rainy season); lane 6) <i>E. faecalis</i> (wetland, dry season); lane 7) <i>E. faecalis</i> (wetland, dry season); and lane 8) <i>E. faecium</i> (wetland, dry season). MWM = Lambda Ladder PFG Marker (New England BioLabs).</p
UPGMA dendrogram based on PFGE patterns of <i>E. faecium</i> isolates from clinical samples (urine) and water samples (wells, wetland and water treatment plant).
<p>The UPGMA dendrogram was constructed with the PFGE patterns of 7 strains using the NTSYS-pc program and Jacquard’s coefficient. Mantel test r = 0.76432, p = 0.999.</p
UPGMA dendrogram based on the PFGE patterns of <i>E. faecalis</i> isolates from clinical samples (blood, pleural fluid, urine, wounds, and other respiratory sites) and water samples (wells, wetland and water treatment plant).
<p>The UPGMA dendrogram was constructed with the PFGE patterns of 21 strains using the NTSYS-pc program and Jacquard’s coefficient. Mantel test r = 0.75389, p = 1.0.</p
Percentages of antibiotic resistance for the <i>E. faecium</i> and <i>E. faecalis</i> isolates from clinical and water samples.
a<p>Interpretive criteria are according to CLSI, 2008 (Clinical and Laboratory Standards Institute, 2008); Amp = ampicillin, Fd = nitrofurantoin, Imp = imipenem, Rif = rifampin, Te = tetracycline, Va = vancomycin, HLG = high-level resistance to gentamicin, and HLS = high-level resistance to streptomycin.</p>b<p>The numbers in parentheses are the numbers of strains tested.</p>*<p>Four and **two strains had intermediate resistance to vancomycin (8 µL/mL). Clinical samples (blood, cerebrospinal fluid, eye, liver, peripheral venous catheter, pleural fluid, sputum, urine, wound, and respiratory system). Water samples (groundwater for human use and consumption (wells), water from the Xochimilco wetland and water from a water treatment plant (water used for agricultural irrigation).</p>§<p>Fisher-Freeman-Halton exact test. NS = not significant.</p
Strains with discordant results from the multiplex PCR assay and a commercial kit.
<p>Strains with discordant results from the multiplex PCR assay and a commercial kit.</p
Biochemical profiles of <i>E. faecium</i> and <i>E. faecalis</i> strains from clinical and water samples.
a<p>All strains hydrolyzed esculin and grew in 40% bile and 6.5% NaCl.</p>b<p>Isolated strain from blood, cerebrospinal fluid, eyes, livers, peripheral venous catheters, pleural fluid, sputum, urine, wounds, and the respiratory system).</p>c<p>Isolated strains from groundwater for human use and consumption (wells), water from the Xochimilco wetland, and water from a water treatment plant (used for agricultural irrigation).</p
Multiplex PCR assay patterns for <i>E. faecium</i> and <i>E. faecalis</i>.
<p>Lane 1) <i>E. faecalis</i> (other respiratory); lane 2) <i>E. faecium</i> (other respiratory); lane 3) <i>E. faecalis</i> (wetland, rainy season); lane 4) <i>E. faecium</i> (water treatment plant); lane 5) <i>E. faecalis</i> (water treatment plant); lane 6) <i>E. faecium</i> (wetland, rainy season); lane 7) <i>E. faecium</i> EF1 (positive control); and lane 8) <i>E. faecalis</i> ATCC 29212 (positive control).</p