Danny Arroyave ZuluagaEstudiante de III semestre, MedicinaUniversidad Pontificia Bolivariana

Morphologically Staphylococcus are gram-positive cocci.

It grows best in the middle mannitol salt agar and blood.

It is a facultative anaerobic coco. Producing catalase. Has medical significance especially S.

aureus, and human addition to it, the S. saprophyticus and S. epidermidis.

INTRODUCTIONStaphylococcus

Staphylococcus epidermidis Consisting of Gram-positive cocci.

Grows by aerobic respiration.

We can found in the skin of humans and animals and mucous membranes.

It is sensitive to the antibiotic novobiocin.

It is used to determine the genetic information of an organism, or genotype, and to distinguish it from the rest.

Viruses or bacteria: extension pathogen-associated gene characterization diseases.

Human: paternity tests to determine the existence of kinship.

Genotyping

Genotyping can be applied in this case, since you have to investigate the genetic information in order to know the genus and species of the organism, and it is also important to know that disease can be associated and patient treatment.

Relation

To investigate the pathogenesis of bloodstream infection by Staphylococcus

epidermidis, using the molecular epidemiology, in high-risk neonates.

OBJETIVE

Sólo se incluyeron 63 de 318 neonatos, de forma aleatoria.

Sólo neonatos de alto riesgo.

Que tuvieran un CVC por mas de 24h.

Por cada 1000 catéteres, el 15.1 presentaban la infección, y el 12.6 de los neonatos pesaban menos de 1500g.

La tasa de mortalidad fue diferente en los neonatos que tenían un peso menor a 1500g.

MATERIALES Y MÉTODOSPacientes

CATETERESCatéter Característica

Umbilical Permite tomar sangre de un bebé en diferentes momentos

FlebotomíaEs la extracción de sangre desde una vena periférica.

PICC(Catéter central de inserción

periférica)

Es una forma de acceso intravenoso que se puede utilizar durante un período prolongado de tiempo.

Se obtuvieron muestras de sangre de PICC.

Se realizaron hemocultivos con 1.0ml de sangre del paciente.

Los cultivos que dieron un resultado positivos se subcultivaron adicionalmente en placas con agar sangre.

Se determino su pureza y se observar su morfología y color específico.

HEMOCULTIVO

Las cepas fueron sometidas a pruebas de catalasa y coagulasa para determinar la especie.

Los análisis moleculares se realizaron en Staphylococcus coagulasa negativa.

Se utilizó el sistema RapID STAPH PLUS (Oxoid) para confirmar su identidad.

IDENTIFICACIÓN

Son reacciones que amplifican simultáneamente diferentes secuencias diana.

Nos permite la detección e identificación simultanea de distintos genes de interés.

PCR MULTIPLE

Es una técnica de electroforesis en gel de campo pulsado que permite la resolución de grandes fragmentos de ADN que no pueden ser resueltos por electroforesis en gel convencional.

CONTOUR-CLAMPED HOMOGENEOUS ELECTRIC FIELD (CHEF)

mecA: Le permite a una bacteria la resistencia a los antibióticos, tales como la meticilina, penicilina y otros antibióticos similares.

icaAD: Produce una biofilm la cual le da una multiresistencia a la bacteria

GENES mecA y icaAD

RESULTADOS

Fig. 1. Dendogram of genotypic strains of Staphylococcus epidermidis after fragmentation with restriction enzyme SmaI and computer analysis of PFGE

Pte 1 Pte 2Pte 3Pte 4Pte

5(negro)Pte 6

DISCUSSIONAUTHOR WHAT DID HE SAY? THEY ARE AGREE?

YES OR NOT

Garland et al... 2008

“Most catheter-related BSIs in neonates with PICCs are caused by CoNS and derive from intraluminal contamination”

NO

Mahieu et al..2001

“Certain manipulations and disconnection of the central venous catheter, which necessitates disinfection of the catheter hub, increase the risk of CABSI, while other, protect against CABSI in neonates.

YES

Conclusions

1. Even knowing that it must have a very good asepsis in these procedures, do not respect, and something that can cause an alteration in patients, and therefore the results.

2. You have to study very well by other adults and infants, because the pathogenesis is very different, and the sources of infection of the CVC can be very different.

Conclusions

3. The study CVC used by phlebotomy, and we know that this type of puncture presents high risks of infection and can cause other diseases, having other ways like PICC having a much higher margin of safety should be used these to a study of more reliable results.

4. It must be quickly identified as the mecA gene and icaAD as to generate a resistance to antibiotics, are decreasing the chance of survival of the patient, and increasing the time of treatment, therefore, cost.

MAPA CONCEPTUAL