changes in the molecular epidemiological characteristics of methicillin resistant
TRANSCRIPT
![Page 1: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/1.jpg)
Changes in the Molecular
Epidemiological Characteristics of
Methicillin-Resistant Staphylococcus aureus in a Neonatal Intensive
Care Unit
Alison J. Caray, MD
![Page 2: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/2.jpg)
INTRODUCTIINTRODUCTIONON
![Page 3: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/3.jpg)
![Page 4: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/4.jpg)
GENERAL GENERAL OBJECTIVEOBJECTIVE
![Page 5: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/5.jpg)
“To determine whether the molecular
epidemiological characteristics of
methicillin-resistant Staphylococcus
aureus (MRSA) had changed in a level III neonatal intensive care unit (NICU)”
![Page 6: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/6.jpg)
MATERIALES MATERIALES Y METODOSY METODOS
![Page 7: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/7.jpg)
Revisión retrospectiva de Historias Clínicas.Expansión de la unidad de cuidados intensivos neonatales.Características de los pacientes en las diferentes etapas del estudio.Condición de los pacientes.
El estudio fue aprobado por la junta de revisión institucional de la Universidad de Columbia, que concede una exención de
la documentación del consentimiento informado.
![Page 8: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/8.jpg)
Separa moléculas de ADN en agarosa sometiéndola a campos eléctricos que alternan en dos direcciones.Tipificación celular.Moléculas desde 20 Kpbs hasta 10 KbpsCrecimiento, lisis y corte con enzima de restricción. CHEF, Clamped homogeneous electric field.Determinación de nuevas cepas de MRSA.
![Page 9: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/9.jpg)
Técnica desarrollada por Kary Mullis.Amplificación directa de un gen o fragmento de DNA o indirecta de RNA.Es metodológica mas no analítica •Desnaturalización del DNA.•Hibridación con un primer.•Replicación por DNA Polimerasa de la hebra sencilla
![Page 10: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/10.jpg)
Se utilizaron pruebas para la identificacion de especies y la determinacion de los perfiles de suceptibilidad antimicrobiana de las cepas de Staphylococcus Aureus. Los aislamientos se caracterizaron como sensibles, intermedias o resistentes a la oxacilina, acorde con el criterio establecido.
![Page 11: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/11.jpg)
Cultivos de vigilancia a los neonatos de otras instituciones, tomando precauciones de contagio por contacto. Inclusión de muestras del área periumbilical, de la axila y de la ingle. Aislamiento de neonatos con brote.Medidas de descolonización. Cultivos de vigilancia del personal de salud.Adecuada limpieza.
![Page 12: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/12.jpg)
RESULTADOSRESULTADOS
![Page 13: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/13.jpg)
![Page 14: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/14.jpg)
Patrones de sensibilidad antimicrobiana similares. Suceptibles a la rifampicina, clindamicina, tetraciclina y trimetropin-sulbactam. Resistentes a la eritromicina y levofloxacina. USA 300 a la Gentamicina.
![Page 15: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/15.jpg)
Pulsed-field gel electrophoresis patterns of each dominant clonal methicillin-resistant Staphylococcus aureus type isolated during the study period. Lane 1, molecular size ladder; lane 2, infected neonate 1; lane 3, colonized neonate 2; lane 4, colonized HCW 1; lane 5, infected neonate 3; lane 6, colonized neonate 4; lane 7, colonized HCW 2; lane 8, infected neonate 5; lane 9, colonized neonate 6; lane 10, colonized HCW 3; lane 11, infected neonate 7; lane 12, colonized neonate 8; lane 13, molecular size ladder.
FIGURA 1FIGURA 1
![Page 16: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/16.jpg)
DISCUSSIONDISCUSSION
![Page 17: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/17.jpg)
![Page 18: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/18.jpg)
CONCLUSIONCONCLUSIONSS
![Page 19: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/19.jpg)
In my opinion the study was complete and clear, the investigators used the apropiated molecular techniques to the study objective.
In the study is evident the diversity of clones finded as a result of the molecular tests, then the molecular epidemiological characteristics had changed.
![Page 20: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/20.jpg)
The infection and colonization by Methicillin-Resistant Staphylococcus aureus management is delicated and required some special cares.
Neonates who pesents events that was considered outbreak used to be more dangerous than the other infected and colonized neonates.
![Page 21: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/21.jpg)
REFERENCIASREFERENCIAS
![Page 22: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/22.jpg)
MARTINEZ SANCHEZ, Lina Maria. Biologia Molecular. Quinta edicion-Medellin: UPB,2009. 314P
http://www.nphl.org/documents/PFGE.pdf
http://journals.tubitak.gov.tr/biology/issues/biy-01-25-4/biy-25-4-6-0006-5.pdf
![Page 23: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/23.jpg)
ANEXOSANEXOS
![Page 24: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/24.jpg)
![Page 25: Changes in the molecular epidemiological characteristics of methicillin resistant](https://reader036.vdocuments.us/reader036/viewer/2022081602/556b6368d8b42a280c8b4e14/html5/thumbnails/25.jpg)
“Un científico debe tomarse la libertad de plantear cualquier
cuestión, de dudar de cualquier afirmación y de corregir errores”
Julius Robert Oppenheimer (1904-1967) Físico estadounidense.