Aspectos fenotípicos e moleculares de isolados de Acinetobacter baumannii relacionados à infecção nosocomial

Acinetobacter baumannii, com sua capacidade de acumular resistência aos antibióticos e o seu potencial de formar biofilme, é uma das principais ameaças para infecções em ambiente hospitalar, chegando a se constituir problema de saúde pública. A resistência aos carbapenêmicos geralmente ocorre devido à expressão de oxacilinases e metalo-β- lactamases e a formação de biofilme pode estar relacionada à presença dos genes bap e blaPER-1. Focando estas características, foram analisados 67 isolados de A. baumannii relacionados à infecção nosocomial provenientes de hospital da rede pública de saúde em Pernambuco. Foram obtidas informações através da amplificação e sequenciamento dos genes 16S rDNA, dos genes codificadores de oxacilinases e de metalo-β-lactamases e de genes relacionados à produção de biofilme As sequências do 16S rDNA confirmaram a identificação de 66 dos isolados; o outro isolado apresentou limitação em sua identificação. O gene blaOXA-143-like foi encontrado em 34 isolados (50,7%), blaOXA-23-like em 12 isolados (17,9%), blaOXA-24-like em 10 isolados (14,9%) e o gene, blaOXA-51-like, intrínseco, foi encontrado em 66 isolados (98,5%) e apresentou polimorfismo, indicando-o como potencial marcador para tipagem molecular. Os genes blaOXA-58-like, vim, spm, imp e blaPER-1 não foram encontrados. O gene bap foi encontrado em 58 isolados (86,5%), destes, 18 isolados (31%) apresentaram um produto de amplificação maior que o esperado. A análise das sequências mostrou que nestes isolados havia uma inserção do gene dacD, relacionado a proteína ligadora de penicilina (PBP), o qual pode ter inativado o gene bap e causado diminuição na produção de biofilme observada no teste fenotípico. O teste fenotípico para avaliar a formação de biofilme apresentou aderência positiva e moderada em 37 isolados (55,2%). Estes achados apontam a necessidade de um monitoramento acurado do A. baumannii para orientar o tratamento e controle no ambiente hospitalar.

Prevalência e susceptibilidade antimicrobiana de Staphylococcusspp. em quadros de saúde e doença periodontal

The aim of this study was determine the prevalence and antimicrobial susceptibility of Staphylococcus spp. from patients with periodontal disease and periodontally healthy, correlate them with factors to host, local environment and traits of the diseases. To this, thirty adults from 19 to 55 years old were selected. They had not periodontal treatment and no antibiotic or antimicrobial was administered during three previous months. From these individuals, sites periodontally healthy, with chronic gingivitis and/or periodontitis were analyzed. Eighteen subgingival dental biofilm samples were collected through sterile paper points being six from each tooth randomly selected, representing conditions mentioned. They were transported to Oral Microbiology laboratory, plated onto Mannitol Salt Agar (MSA) and incubated at 370C in air for 48 h. Staphylococcus spp. were identified by colonial morphology, Gram stain, catalase reaction, susceptibility to bacitracin and coagulase activity. After identification, strains were submitted to the antibiotic susceptibility test with 12 antimicrobials, based on Kirby-Bauer technique. To establish the relation between coagulase-negative Staphylococcus (CSN) presence and their infection levels and host factors, local environment and traits of diseases were used Chi-square, Mann-Whitney and Kruskal-Wallis tests to a confidence level of 95%. 86,7% subjects harbored CSN in 11,7% periodontal sites. These prevalence were 12,1% in healthy sites, 11,7% in chronic gingivitis, 13,5% in slight chronic periodontitis, 6,75% in moderate chronic periodontitis and in sites with advance chronic periodontitis was not isolated CSN, without difference among them (p = 0,672). There was no significant difference to presence and infection levels of CSN as related to host factors, local environm ent and traits of the diseases. Amongst the 74 samples of CSN isolated, the biggest resistance was observed to penicillin (55,4%), erythromycin (32,4%), tetracycline (12,16%) and clindamycin (9,4%). 5,3% of the isolates were resistant to oxacilin and methicillin. No resistance was observed to ciprofloxacin, rifampicin and vancomycin. It was concluded that staphylococci are found in low numbers in healthy or sick periodontal sites in a similar ratio. However, a trend was observed to a reduction in staphylococci occurrence toward more advanced stages of the disease. This low prevalence was not related to any variables analyzed. Susceptibility profile to antibiotics demonstrates a raised resistance to penicillin and a low one to methicillin. To erythromycin, tetracycline and clindamycin was observed a significant resistance

Staphylococcus spp. in the oral cavity and periodontal pockets of chronic periodontitis patients

Staphylococcus spp. não são usualmente isolados a partir da cavidade bucal. Quando presentes, são considerados pertencentes à microbiota transitória. Indivíduos que apresentam doença periodontal representam possíveis reservatórios dessas bactérias oportunistas na cavidade bucal. O uso de antibióticos para o tratamento da doença periodontal ou outras infecções pode predispor o aumento do número de Staphylococcus spp. na boca, pois estes adquirem facilmente resistência aos antibióticos, podendo resultar em superinfecção. O objetivo deste estudo foi verificar a presença de Staphylococcus spp. na cavidade bucal e nas bolsas periodontais de pacientes com periodontite crônica; identificar as cepas isoladas; verificar a relação entre a presença de Staphylococcus spp. na cavidade bucal e presença de bolsa periodontal. Participaram deste estudo 88 pacientes, entre 25 e 60 anos de idade e apresentando periodontite crônica, com pelo menos dois sítios com profundidade de sondagem maior ou igual a 5mm. Após anamnese e exame clínico periodontal foram feitas coletas de material da bolsa periodontal com cones de papel e da cavidade bucal por meio de bochechos. do total de pacientes 37,50% apresentaram Staphylococcus spp. na bolsa periodontal e 61,36% na cavidade bucal, sendo que 27,27% apresentaram a bactéria nos 2 sítios. S. epidermidis foi a espécie mais prevalente para bolsa periodontal (15,9%) e cavidade bucal (27,27%). Não houve diferença estatística significante quanto à presença desses microrganismos entre as faixas etárias e aumento da profundidade de sondagem. A presença de bactérias oportunistas na cavidade bucal pode representar dificuldades para a manutenção do tratamento periodontal.

Isolation of Shiga toxigenic Escherichia coli from butcheries in Taquaritinga city, State of São Paulo, Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Caracterização molecular de Staphylococcus sp, isolados de leite de vacas com mastite, em diferenes regiões do estado de São Paulo

Pós-graduação em Biologia Geral e Aplicada - IBB

Epidemiologia molecular e fatores de risco para aquisição de clones endêmicos de Staphylococcus aureus resistente à Meticilina (MRSA) em hospital de ensino

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Avaliação do potencial antimicrobiano de Pouteria spp. e de triterpenos quinonametídeos com enfoque no Helicobacter pylori

Pós-graduação em Ciências Farmacêuticas - FCFAR

Aplicação e viabilidade de micro-organisos potencialmente probióticos em embutido cárneo fermentado

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Prevalência, Virulência e sensibilidade às terapias antimicrobianas das cepas de enterecoccus faecalis e enterococcus faecium isoladas de infecções endodônticas

Pós-graduação em Biopatologia Bucal - ICT

Caracterização de segurança e tecnológica de bactérias acidoláticas termofílicas autóctones e aplicação em queijo parmesão

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Capacidade de adesão, invasão e produção de enterotoxinas de Staphylococcus aureus isolados de leite de vacas com mastite subclínica e leite humano de um banco de leite

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Capacidade de adesão, invasão e produção de enterotoxinas de Staphylococcus aureus isolados de leite de vacas com mastite subclínica e leite humano de um banco de leite

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Infecções de corrente sanguínea por bactérias multirresistentes em UTI de tratamento de queimados: experiência de 4 anos

INTRODUÇÃO: O conhecimento do perfil de resistência aos antibióticos das bactérias de um nosocômio é essencial para orientar tratamento adequado dos pacientes. Isso é especialmente importante para os pacientes mais graves, já que o tratamento deve ser instituído antes do resultado das culturas. O objetivo deste estudo foi analisar o perfil das bactérias multirresistentes encontradas nas hemoculturas de pacientes admitidos na Unidade de Tratamento Intensivo (UTI) da Unidade de Queimados do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. MÉTODO: Foram analisados 178 pacientes internados na UTI para tratamento de queimados, no período de 2009 a 2011, sendo 131 do sexo masculino, com média de idade de 29,2 anos. RESULTADOS: Entre os pacientes analisados, 80 (44,9%) apresentaram hemocultura periférica positiva, sendo 66 (82,5%) casos com bactérias multirresistentes. Em 48 pacientes, foram isoladas Staphylococcus sp., que se apresentaram resistentes à oxacilina em 33 deles. Em 11 pacientes, foram isoladas Acinetobacter baumanii, que se apresentaram resistentes a imipenem em 8 casos. Em 19 pacientes, foram isoladas Pseudomonas sp., resistentes a imipenem em 16 casos. Em 10 pacientes foram isoladas Enterobacter sp., resistentes a amicacina e ciprofloxacina em 2 casos. A presença de bactérias multirresistentes não foi associada a maior ocorrência de óbitos, porém foi verificado maior tempo de internação (52,6 dias vs. 36,3 dias para os grupos com e sem bactérias multirresistentes, respectivamente; P = 0,0306). Não foi encontrada interação significante entre superfície corpórea queimada e presença de bactérias MR. CONCLUSÕES: A presença de bactérias multirresistentes é um problema grave, tanto pela prevalência como pela morbidade e mortalidade associadas.

Chemical characterization and evaluation of biological activity of Cynara cardunculus extractable compounds

The Mediterranean species Cynara cardunculus L. is recognized in the traditional medicine, for their hepatoprotective and choleretic effects. Biomass of C. cardunculus L. var. altilis (DC), or cultivated cardoon, may be explored not only for the production of energy and pulp fibers, but also for the extraction of bioactive compounds. The chemical characterization of extractable components, namely terpenic and phenolic compounds, may valorize the cultivated cardoon plantation, due to their antioxidant, antitumoral and antimicrobial activities. In this study, the chemical composition of lipophilic and phenolic fractions of C. cardunculus L. var. altilis (DC), cultivated in the south of Portugal (Baixo Alentejo region) was characterized in detail, intending the integral valorization of its biomass. The biological activity of cultivated cardoon extracts was evaluated in terms of antioxidant, human tumor cell antiproliferative and antibacterial effects. Gas chromatography-mass spectrometry (GC-MS) was used for the chemical analysis of lipophilic compounds. Sixty-five lipophilic compounds were identified, from which 1 sesquiterpene lactone and 4 pentacyclic triterpenes were described, for the first time, as cultivated cardoon components, such as: deacylcynaropicrin, acetates of β- and α-amyrin, lupenyl acetate and ψ-taraxasteryl acetate. Sesquiterpene lactones were the major family of lipophilic components of leaves (≈94.5 g/kg), mostly represented by cynaropicrin (≈87.4 g/kg). Pentacyclic triterpenes were also detected, in considerably high contents, in the remaining parts of cultivated cardoon, especially in the florets (≈27.5 g/kg). Taraxasteryl acetate was the main pentacyclic triterpene (≈8.9 g/kg in florets). High pressure liquid chromatography-mass spectrometry (HPLC-MS) was utilized for the chemical analysis of phenolic compounds. Among the identified 28 phenolic compounds, eriodictyol hexoside was reported for the first time as C. cardunculus L. component, and 6 as cultivated cardoon components, namely 1,4-di-O-caffeoylquinic acid, naringenin 7-O-glucoside, naringenin rutinoside, naringenin, luteolin acetylhexoside and apigenin acetylhexoside. The highest content of the identified phenolic compounds was observed in the florets (≈12.6 g/kg). Stalks outer part contained the highest hydroxycinnamic acids abundance (≈10.3 g/kg), and florets presented the highest flavonoids content (≈10.3 g/kg). The antioxidant activity of phenolic fraction was examined through 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging assay. Stalks outer part, and receptacles and bracts extracts demonstrated the highest antioxidant effect on DPPH (IC50 of 34.35 μg/mL and 35.25 μg/mL, respectively). (cont.) abstract (cont.) The DPPH scavenging effect was linearly correlated with the total contents of hydroxycinnamic acids (r = -0.990). The in vitro antiproliferative activity of cultivated cardoon lipophilic and phenolic extracts was evaluated on a human tumor cells line of triple-negative breast cancer (MDA-MB-231), one of the most refractory human cancers to conventional therapeutics. After 48 h of exposition, leaves lipophilic extract showed higher inhibitory effect (IC50 = 10.39 μg/mL) than florets lipophilic extract (IC50 = 315.22 μg/mL), upon MDA-MB-231 cellular viability. Pure compound of cynaropicrin, representative of the main compound identified in leaves lipophilic extract, also prevented the cell proliferation of MDA-MB-231 (IC50 = 17.86 μM). MDA-MB-231 cells were much more resistant to the 48 h- treatment with phenolic extracts of stalks outer part (IC50 = 3341.20 μg/mL) and florets (IC50 > 4500 μg/mL), and also with the pure compound of 1,5-di-O-caffeoylquinic acid (IC50 = 1741.69 μM). MDA-MB-231 cells were exposed, for 48 h, to the respective IC50 concentrations of leaves lipophilic extract and pure compound of cynaropicrin, in order to understand their ability in modelling cellular responses, and consequently important potentially signaling pathways for the cellular viability decrease. Leaves lipophilic extract increased the caspase-3 enzymatic activity, contrarily to pure compound of cynaropicrin. Additionally, leaves lipophilic extract and pure compound of cynaropicrin caused G2 cell cycle arrest, possibly by upregulating the p21Waf1/Cip1 and the accumulation of phospho-Tyr15-CDK1 and cyclin B1. The inhibitory effects of leaves lipophilic extract and cynaropicrin pure compound, against the MDA-MB-231 cell proliferation, may also be related to the downregulation of phospho-Ser473-Akt. The antibacterial activity of cultivated cardoon lipophilic and phenolic extracts was assessed, for the first time, on two multidrug-resistant bacteria, such as the Gram-negative Pseudomonas aeruginosa PAO1 and the Gram-positive methicillin-resistant Staphylococcus aureus (MRSA), two of the main bacteria responsible for health care-associated infections. Accordingly, the minimum inhibitory concentrations (MIC) were determined. Lipophilic and phenolic extracts of florets did not have antibacterial activity on P. aeruginosa PAO1 and MRSA (MIC > 2048 μg/mL). Leaves lipophilic extract did not prevent the P. aeruginosa PAO1 growth, but pure compound of cynaropicrin was slightly active (MIC = 2048 μg/mL). Leaves lipophilic extract and pure compound of cynaropicrin blocked MRSA growth (MIC of 1024 and 256 μg/mL, respectively). The scientific knowledge revealed in this thesis, either by the chemical viewpoint, or by the biological viewpoint, contributes for the valorization of C. cardunculus L. var. altilis (DC) biomass. Cultivated cardoon has potential to be exploited as source of bioactive compounds, in conciliation with other valorization pathways, and Portuguese traditional cheeses manufacturing.

Sources of antibiotic resistance in the environment

The discovery of antibiotics was a major breakthrough in medicine. However, short after their introduction in clinical practice resistant bacteria were detected. Nowadays, antibiotic resistance constitutes a serious public health problem. In hospital settings, with high resistance levels, reducing drastically the therapeutic options. Carbapenems are last-resort antibiotics used in Portugal, only in hospitals, to treat serious infections. Bacterial resistance towards this class of antibiotics has increased during last years. In Gram-negative bacteria the production of carbapenemases is a common resistance mechanism. OXA-48 is a carbapenemase of Ambler class D and represents a major concern for human health. It is frequently detected in clinical isolates of Enterobacteriaceae. There are few studies suggesting that genes encoding for OXA-48 variants originated from genes present in the chromosome of members of genus Shewanella, and have disseminated to Enterobacteriaceae members, associated with mobile genetic elements. The aim of this study was to characterize strains from different sources of Shewanella to confirm its role as OXA-48 progenitor. For this, the phylogenetic affiliation of 33 strains of Shewanella was performed by 16SrDNA and gyrB sequencing. The most common species were S. hafniensis and S. xiamenensis, but also S. aestuarii, S. baltica, S. indica, S. haliotis, S. putrefaciens, S. algidipiscicola, S. irciniae, S. algae and S. fodinae were identified. blaOXA-48-like genes were detected in 21 isolates: S. hafniensis (8/8), S. xiamenensis (5/5), S. baltica (4/4), S. algae (1/1), S. fodinae (1/1), S. putrefaciens (1/2) and S. algidipiscicola (1/2). Sequence analysis revealed that genes encoded enzymes identical to OXA-48, OXA-181 and OXA-204 but also new variants differing from OXA-48 from 2 to 81 aminoacids. Genetic context analysis revealed the C15 gene upstream and lysR gene downstream, identical to what has been identified so far flanking blaOXA-48-like genes in Shewanella spp. The assessment of antibiotic susceptibility was performed for all isolates using the disk diffusion method. In general, it was observed a great sensitivity for all antibiotics except to amoxicillin and aztreonam. Multidrug resistance was detected in only 1 isolate. Other resistance genes and the presence of integrons were not identified. Plasmids were detected in 30.3% isolates (10/ 33). These results reinforce the role of Shewanella spp. as origin of blaOXA-48-like genes.