Moraxella Catarrhalis

lunes, junio 19, 2006

DIAGNÓSTICO Y TRATAMIENTO

Se determino que Moraxella Catarrhalis no es un agente primario en las infecciones del tracto respiratorio inferior; sin embargo, la historia clinica del paciente debe ser tomada en cuenta para sospechar la presencia de este microorganismo y el subsecuente tratamiento.

Para el diagnostico se cultivan muestras de Esputo, Sangre, Seccreciones bronquiales, Aspirado transtraqueal, Lavado broncoalveolar y Biopsia pulmonar.

Un método de diferenciación con la Neisseria, es que la Moraxella Catarrhalis no fermenta los carbohidratos y produce DNasa. Además produce Butirato esterasa, que constituye la base de la prueba fluorométrica rápida para identificarla. En la tinción aparecen bacilos, cocobacilos o cocos pequeños Gramnegativos.





La prevalencia de colonización de M. Catarrhalis en tracto respiratorio superior es similar a la de otros patógenos respiratorios.Este microorganismo se encuentra colonizando el tracto respiratorio en humanos y varios animales. La mayoría de los aislamientos producen B-lactamasa, y son resistentes a la penicilina; sin embargo, estas bacterias son sensibles de manera uniforme a la mayor parte de los otros antibióticos.


Este microorganismo presenta una alta resistencia a beta-lactámicos como la penicilina, ampicilina y amoxicilina. El fármaco de primera elección es el TMP-SMZ (mezcla de una parte de trimetoprim y cinco partes de sulfametoxazol). Esta bacteria presenta sensibilidad a la cefalosporinas, eritromicina, tatraciclina, amikacina, cefalotina, cefotaxima, imipenem, meropenem, cloranfenicol, eritromicina y la combinación de las penicilinas con un inhibidor de la B-lactamasa (p. ej., ácido clavulánico).

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