An acute infection of the nail fold, called paronychia, is a common clinical problem. The basis for the implementation of the treatment is the result of microbiological examination. Due to the rapid and painful course of infection, usually an empirical antimicrobial treatment prior to obtaining microbiological test results is introduced.The microbial analysis of acute infections of the nail fold.The study included 32 tests conducted on 31 patients of the Department of Dermatology. Microbiological analysis was performed with the use of the so-called bait thread test.In 73% of analyzed cases microbiological examination revealed mixed microbiological flora. Most cultured microorganisms were: Enterococcus faecalis (14%), Staphylococcus aureus (12%), Candida albicans (9%), Enterobacter cloacae (8%), and Klebsiella pneumoniae (7%). Most cultured bacteria belonged to the families or genera of Enterobacteriaceae (36%), other cultured bacteria were staphylococci (26%), enterococci (16%), Candida species (14%), and Gram-negative non-fermenting bacilli (8%).The acute infection of the nail fold in the vast majority of cases is caused by mixed bacterial flora. A profile of isolated microorganisms suggests that the cause of the infection can be associated with neglect of hygiene. Fluoroquinolone and fusidic acid are recommended as the empirical therapy. Microbiological examination is the basis for the appropriate final treatment.
Introduction: Staphylococcus aureus (S. aureus) represents a significant aetiological factor in infections of skin and soft tissues. Resistance to vancomycin is very rare. In recent years the MIC creep phenomenon has been noted. At present, it is suggested that S. aureus strains with vancomycin minimal inhibitory concentration (MIC) at a level > 1 μg/ml poorly respond to treatment. Aim: The study was aimed to compare MIC evaluated in the automatic system of Vitek with the real MIC of van- comycin for S. aureus strains isolated from patients treated in the Department of Dermatology, Poznan University of Medical Sciences. Material and methods: Material for the studies involved 80 smears sampled from dermal lesions in patients diag- nosed and treated in the Department of Dermatology, Poznan University of Medical Sciences in Poznan between May 2008 and December 2010. Results: Methicillin-sensitive S. aureus strains (MSSA) were isolated in 76 cases (95%), while methicillin-resistant S. aureus (MRSA) - in 4 cases (5%). Using the automatic Vitek technique in 72 cases (90%), the obtained vancomycin MIC for S. aureus amounted to ≤ 0.5 μg/ml, in 5 cases to 1 μg/ml and in 3 cases to 2 μg/ml. Using Etest technique, the real MIC amounted in one case to 0.5 μg/ml, in 1 case to 0.75 μg/ml, in 1 case to 1 μg/ml, in 19 cases to 1.5 μg/ml and in 58 cases to 2.0 μg/ml. Conclusions: Due to the MIC creep phenomenon and extensive diversities obtained in estimates of S. aureus resis- tance to vancomycin, the authors suggest estimating the real MIC.
The aim of the study was a comparison of the MIC (minimal inhibitory concentration) evaluated in the automatic system Vitek 2 and the real MIC of vancomycin by the Etest method for S. aureus strains isolated from clinical materials.Over a twelve-month study period we compared the results obtained with two commercial methods - the automatic system VITEK 2 and the real MIC by Etest - for 359 strains of S. aureus isolated from clinical materials.Most of the strains of S. aureus were cultured from wounds (84), the ear (60) and nose (42). MSSA (methicillin-sensitive Staphylococcus aureus) was isolated in 342 cases and MRSA (methicillin-resistant Staphylococcus aureus) in 17 cases. The test with the Vitek automatic method showed that vancomycin had MIC values of ≤1.0 μg/ml in more than 96% and 2.0 μg/ml in over 3% of cases. Using the Etest technique MIC ≤ 1.0 μg/ml was obtained in only 16.4% of cases and values of >1.0 μg/ml in 83.6% of cases.In view of such big differences between the MIC values obtained with the two methods the authors suggest that the Etest method of assaying the real MIC is more useful than the automatic method.
Species and resistance rate of current pathogens is important for determining the appropriate treatment. P. aeruginosa is an essential issue in the group of patients with ear problems. The number of infections and relapses caused by this pathogen has been increasing with high percentage of antibiotic resistant strains responsible for treatment failure. The purpose of this work was to present the problem of increasing resistance of Pseudomonas aeruginosa in patients of ENT Department of Poznan University of Medical Sciences between 2005–2007. During that time at our Clinic 644 biological samples were taken to carry out a bacteriological examination. All materials were analyzed to assess the prevalence of Pseudomonas aeruginosa as an etiologic factor of infections. The groups of patients treated operatively and in outpatient clinic were taken into consideration. Pseudomonas aeruginosa was found in 89 samples; most cases in 2007 (53 strains), which constitutes 18% of all samples analyzed. Predominatingly (in 54 samples) that pathological culture was found in materials coming from ears. There was noticed a 20% – growth in the number of P. aeruginosa infections in 2007 in relation to 2005. Most of the strains (93%) were susceptible to imipenem, piperacilin and tazobactam, 83% of the strains – to ciprofloxacin, 86% – to ceftazidim. Overuse of cotrimoxazol, doxycyclin and cefuroxim in empiric treatment, Pseudomonas aeruginosa strains are naturally resistant to which, is responsible for the P. aeruginosa resistance to most commonly used antibiotics.
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