Vancomycin-resistant enterococci (VRE) have emerged as important pathogenic bacteria all over the world. The first outbreak of infections due to VRE occurred in Rosario in 2000 due to Enterococcus faecium with the Van-A phenotype. As the use of contact isolation precautions for VRE-colonized and infected patients was recommended in order to prevent the spread of vancomycin resistance, a study to determine the level of fecal colonization among patients hospitalized in critical areas was conducted. Samples of rectal swabs were obtained from patients hospitalized in intensive care units of four hospitals in Rosario looking for VRE. Sixty-four cases of colonized patients with VRE were detected among the 565 patients studied. Sixty E. faecium, and two Enterococcus faecalis with the Van-A phenotype, and two Enterococcus gallinarum with the Van-C phenotype were isolated. All the E. faecium and E. faecalis isolates showed MIC > 256 ug/mL against vancomycin, and were susceptible to Linezolid.

Los enterococos vancomicina resistentes (EVR) han emergido como importantes patógenos en todo el mundo. En Rosario, se produjo un brote en 2000, luego de lo cual se los ha detectado en distintos centros hospitalarios de la ciudad. La mayoría de los aislados presentaron el fenotipo Van-A y correspondieron a Enterococcus faecium aunque se ha aislado también Enterococcus faecalis. Es posible la trasmisión nosocomial de estas bacterias por las manos o guantes a partir de pacientes infectados o colonizados. El objetivo del trabajo fue determinar el nivel de colonización fecal de pacientes hospitalizados en áreas críticas de cuatro instituciones asistenciales de esta ciudad. Se tomaron muestras de materia fecal o hisopado anal de pacientes con riesgo de colonización, internados en áreas críticas. Se aislaron 60 E. faecium y 2 E. faecalis con el fenotipo Van-A y 2 Enterococcus gallinarum con resistencia constitutiva, con el fenotipo Van-C. Todos los aislamientos de E faecium y E faecalis mostraron CIMs para vancomicina > 256 ug/mL y fueron sensibles a Linezolid.

Bacterial vaginosis (VB) is a syndrome characterized by overgrowth of endogenous Gram negative bacterial flora and the lack of the normal flora. Within bacterial enzymes, sialidases have been considered a virulence factor of many pathogenic microorganisms colonizing the different mucous membranes. Their presence in vaginal discharges can be correlated with VB. The aim of this study was to detect the activity of this enzyme in women with this syndrome and without clinical evidence of genital infection. Out of a total 112 women studied, 51 were patients with VB and the other 61 women presented normal vaginal flora. For the quantification of enzyme activity, the technique based on the enzymatic hydrolysis of a derivative acid of the acetyl metoxifenil muramic acid was used. In the studied population both groups shared values from 0.5 to 5.1 nmoles of metoxifenol, whereas only 11 out of 52 patients with VB (21.17%), registered more than 5.1 nmoles. The presence of sialidase activity is not enough to confirm VB, except for values greater than 5.5 nmoles of the metoxifenol produced in the enzymatic reaction.

La vaginosis bacteriana (VB) es un síndrome caracterizado por el sobrecrecimiento bacteriano de flora endógena Gram negativa, que desplaza a la flora lactobacilar normal. Dentro de las enzimas bacterianas, las sialidasas han sido consideradas factores de virulencia de muchos microorganismos patógenos que colonizan las distintas mucosas. Su presencia en fluidos vaginales puede estar correlacionada con VB. El propósito de este estudio fue comprobar la actividad de dicha enzima en mujeres con este síndrome y sin evidencia clínica de infección genital. Se estudiaron 112 mujeres (51 fueron pacientes con VB y 61 mujeres con flora colonizante habitual). Para la cuantificación de la actividad sialidasa se empleó la técnica basada en la hidrólisis enzimática de un derivado ácido del ácido metoxifenil acetil murámico. En la población estudiada se encontró que ambos grupos mostraron valores comprendidos entre 0.5 a 5.1 nmoles de metoxifenol, mientras que 11 de 52 pacientes con VB (21.17%), registraron valores superiores a 5.1 nmoles. La presencia de actividad sialidasa solamente no es índice de VB, excepto para valores mayores de 5.5 nmoles de metoxifenol, producidos en la reacción enzimática.

Given the suspected role of mycobacteria in the establishment of disorders with an autoimmune background and joint damage, a study was conducted to analize whether rheumatic symptoms were likely to be present in tuberculosis (TB) patients. To this end, 330 patients with a bacteriologic confirmation of tuberculosis were investigated for the presence of arthritic complaints. The latter were recorded in five of them with rheumatic symptoms mostly involving interphalangeal and metacarpophalanged joints, and preceding the clinical manifestations of the TB illness. Three out of these five patients remained arthritic by the time of the bacteriologic conversion and fulfilled the criteria for the diagnosis of rheumatoid arthritis. In the two remaining patients sputum negativization was accompanied by a disappearance of rheumatic manifestations. These patients were also assessed for their peripheral levels of major T cell subsets as well as for the presence of autoantibodies. Comparisons with a series of non-arthritic TB cases, rheumatoid arthritis patients, and controls revealed that presence of rheumatic manifestations was associated with a different profile of autoantibody formation and T cell subset changes. Evidence recorded in the present study indicates that joint affectation in TB is a rare event, being rather the exception than the rule.

T cells and T cells subsets in peripheral blood of patients with different forms of pulmonary tuberculosis were evaluated to explain some aspects of the immunocompromised state of these subjects. Diagnosis was made by baciloscopy (BAAR), chest roentgenography i.d.r Mantoux, and other clinical analysis. Spontaneous E-Rosette test (RE) was used to quantify Total (RET 4ºC) and Active T cells (REA 37ºC) and the same test after incubation with Theophilline (The) for helper cells (The-re-sistant cells: RETR) and suppressor cells (The-sensitive cells: RETS). Patients were followed for at least 4 months after therapy. The data demonstrate a significant decrease of relative and absolute numbers of Total T-cells and a diminished T helper/T suppressor subset ratio (RETR/RETS) which dropped to less than 1 in untreated patients. Treated patients with a favourable evolution showed a restoration of Total active and helper T cells. RETR/RETS ratio was also significantly increased. In patients with highly positive BAAR, low on negative i.d.r Mantoux, a decreased level of immunocompetent cells was observed. The 3 aspects were associated. Nutritional condition of the patients wal also associated with the predisposition to acquire this disease.

Se evaluaron las poblaciones y subpoblaciones linfocitarias en pacientes con tuberculosis pulmonar antes y durante la terapia relacionando estos valores con la incidencia y evolución de la enfermedad. Pacientes en sus diversas manifestaciones clínicas, vírgenes de tratamiento, se estudiaron por baciloscopía (BAAR), radiología, i.d.r. Mantoux y análisis complementarios. Se cuantificaron mediante la prueba de Rosetas espontáneas (RE) linfocitos T totales y activos (RE a 4ºC y 37ºC), T colaboradores (RE Teofilina Resistentes: RETR) y supresores (RE Teofilina Sensibles: RETS). Los exámenes se repitieron en los mismos sujetos iniciado el tratamiento y en testigos sanos (TS). Se demostró en los pacientes en todas sus formas clínicas un descenso significativo en los valores relativos y absolutos de células T y en la relación RETR/RETS (menor de 1). Existe asociación entre la forma clínica y el número de linfocitos T colaboradores. Los pacientes en tratamiento con evolución favorable, evidenciaron un incremento significativo en los linfocitos T totales, activos, colaboradores y en la relación RETR/RETS. Los enfermos con baciloscopía altamente positiva presentaron i.d.r. Mantoux baja o negativa y marcado descenso de células inmunocompetentes. Se comprobó asociación entre estas tres variables, lo mismo que entre el estado nutricional y la predisposición a contraer la enfermedad.