Evaluation of the in vitro susceptibility and emergence of mutants resistant to ciprofloxacin among multidrug resistant clinical isolates.

Two hundred and seventy-seven multidrug resistant clinical isolates [K. pneumoniae, (N = 87); E coli, (N = 30); Salmonella typhimurium (N = 100); P. aeruginosa, (N = 30); S. aureus, (N = 30)] from hospitalized patients specimens, were tested in vitro for sensitivity to Ciprofloxacin. Application of the disk diffusion test and determination of the minimal inhibitory concentration by the microdilution method indicated that, almost all isolates were sensitive to the drug. Overall, S. aureus and P. aeruginosa were the less sensitive organisms. Ciprofloxacin-resistant mutants occurred at frequencies of > or = 10(-5)/CFU.

Estudo sobre a resistencia aos antimicrobianos em bacterias isoladas de pacientes hospitalizados (Botucatu, 1988-1992)

Since 1988 to 1992, a study about susceptibility to antimicrobial drugs of bacterias isolated from hospitalized patients was performed. The compared susceptibility to important drugs (ampicillin, cephalotin, cefoxitin, ceftaxizime, ceftriaxone, aztreonam, gentamicin, amikacin, pefloxacin, ciprofloxacin, imipenem, oxacillin and vancomycin) was investigated in 1200 strains (300 of each specie) of the prevalent bacterias: E. coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and S. aureus. Minimal inhibitory concentration (MIC) was determined by agar dilution method, using from 0.05 to 256 mcg of each drug per ml of culture medium (Mueller-Hinton). Ranges of MIC, MIC(50%), MIC(90%) and the proportion of resistant strains were determined and permitted to know the 4 drugs that were found to be more active against bacterias; the CIM(90%) values are: E. coli - aztreonam (0.1 mcg/ml), pefloxacin (0.1), ceftazidime (0.25) and ceftriaxone (0.05); K. pneumoniae-aztreonam (0.25) ceftriaxone (0.25), ceftazidime (0.5) and pefloxacin (2.0); P. aeruginosa-imipenem (4.0), aztreonam (16), ceftazidime (16) and ciprofloxacin (16); S. aureus-vancomycin (1.01, ciprofloxacin (8, 0), amikacin (128) and cephalothin (128 mg/ml). The better 'in vitro' antibacterial activity observed was related to: aztreonam (77-100% of the sensitive strains), ceftazidime (50-99,7%), pefloxacin (73-99,7%), ciprofloxacin (80%), imipenem (93%) and vancomycin (100%).

Avaliacao da atividade da nova cefalosporina de quarta geracao cefpiroma contra amostras clinicas isoladas em unidades de terapia intensiva e unidades de oncoematologia de varios hospitais brasileiros

Objective: To evaluate the in vitro activity of the fourth-generation cephalosporin cefpirome in comparison to that of ceftazidime, ceftriaxone, cefotaxime and imipenem in a multicenter study involving nine hospitals from six cities (four states). Material and methods: A total of 804 isolates from patients hospitalized in either intensive care units or Oncology/Hematology units was evaluated. The isolates were collected between June and November of 1995, i.e. before cefpirome became commercially available in Brazil, and susceptibility tested by broth microdilution following the NCCLS procedures. All isolates resistant to cefpirome were retested by B-test. Results: Against Enterobacteriaceae (n = 344), cefpirome demonstrated an activity 2 to 32-fold higher than that of the third-generation cephalosporins (TGCs) and similar to that of imipenem. The percentages of Enterobacteriaceae susceptible were: 88%, 69% and 96% for cefpirome, TGCs and imipenem, respectively, The cefpirome spectrum were greater or equal to that of imipenem against Citrobacter freundii, Enterobacter aerogenes, Morganellao morganii and Serratia marcescens. Against Acinetobacter sp. (n = 77), cefpirome was slightly more active than ceftazidime; however, the percentages of isolates resistant to these compounds were high (84% and 88%, respectively). The activities of cefpirome, ceftazidime and imipenem were very similar against P. aeruginosa isolates (n = 128), with MIC50 (μg/ml) percent susceptible of 8/59%, 8/62% and 4/62% respectively, Against aerobic gram-positive bacteria, the cefpirome activity was 4 to 16-fold higher than that of TGCs but 2 to 8-fold lower than that of imipenem. Conclusion: The results of our study suggest that, in Brazil, cefpirome has a spectrum of activity which is higher than that of the TGCs against aerobic gram-negative (Enterobacteriaceae and non-Enterobacteriaceae) and gram-positive bacteria and similar to that of imipenem against some Enterobacteriaceae species and P. aeruginosa.

Estudo sobre a resistência aos antimicrobianos em bactérias isoladas de pacientes hospitalizados (Botucatu, 1988-1992)

Since 1988 to 1992, a study about susceptibility to antimicrobial drugs of bacterias isolated from hospitalized patients was performed. The compared susceptibility to important drugs (ampicilin, cephalothin, cefoxitin, ceftazidime, ceftriaxone, aztreonam, gentamicin, amikacin, peftoxacin, ciprofloxacin, imipenem, oxacillin and vancomicin) was investigated in 1200 strains (300 of each specie) of the prevalent bacterias: E. coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and S. aureus. Minimal inhibitory concentration (MIC) was determined by agar dilution method, using from 0,05 to 256 mcg of each drug per ml of culture medium (Mueller-Hinton). Ranges of MIC, MIC 50%, MIC 90% and the proportion of resistant strains were determined and permited to know the 4 drugs that were found to be more active against bacterias; the CIM 90% values are: E. coli - aztreonam (0,1 mcg/ml), pefloxacin (0,1), ceftazidime (0,25) and ceftriaxone (0,05); K. pneumoniae - aztreonam (0,25), ceftriaxone (0,25), ceftazidime (0,5) and pefloxacin (2,0); P. aeruginosa - imipenem (4,0), aztreonam (16), ceftazidime (16) and ciprofloxacin (16); S. aureus - vancomicina (1,0), ciprofloxacin (8,0), arnicacina (128) and cephalothin (128 mg/ml). The better in vitro antibacterial activity observed was related to: aztreonam (77-100% of the sensitive strains), ceftazidime (50-99,7%), pefloxacin (73-99,7%), ciprofloxacin(80%), imipenem (93%) and vancomicin (100%).

Population analysis of susceptibility to propolis in reference strains of Staphylococcus aureus and Escherichia coli

Susceptibility to several ethanolic extracts of propolis (EEP) concentrations was tested with the population analysis technique in reference strains of Staphylococcus aureus (ATCC 25923) and Escherichia coli (ATCC 35218). The results of these tests showed that all bacteria were killed by EEP concentrations approximately equal or higher (2.0% v/v - S. aureus; 10.0% v/v - E. coli) than the respective minimal inhibitory concentrations (MIC). Regarding the susceptibility to propolis, there was a homogeneity of data with the respective time kill curves showing a clear bactericidal effect during 6 to 9 h of exposition.

Atividade comparada da cefepima, cefpiroma e amicacina em amostras bacterianas hospitalares

The objective of this study was to evaluate the in vitro activity of cefepime, cefpirome and amikacin against the most prevalent nosocomial bacteria. Initially a prospective study was designed to compare the bacterial susceptibility to the three drugs using 1,022 pathogenic strains. The strains were isolated from hospitalized patients of the Hospital das Clinicas - Faculdade de Medicina de Botucatu, SP, from March to December of 1996, by using the Bauer-Kirby susceptibility diffusion controlled method. The activity of cefepime by the Kirby-Bauer method was significantly higher (χ2, p ≤ 0.05) than cefpirome and amikacin for the following bacteria: P. aeruginosa (72% x 56% x 64%, respectively), Enterobacter cloacae (98% x 88% x 80%) and total strains (79.5% x 74.3% x 76.8%). Cefpirome exhibited higher activity than cefepime only to Enterococcus faecalis (42% x 23%). In the 12 other bacterial groups studied the sensibility of the three drugs was similar (χ2, p ≥ 0.05). The minimal inhibitory concentration (MIC) for 127 bacterial strains - Enterobacter cloacae (12), Citrobacter sp (15), Pseudomonas aeruginosa (50), Acinetobacter baumannii (12), BGNF others (22) and Enterococcus faecalis (16)-from the same origin previously described and isolated during 1997, was determined by E-test. Ranges of MIC intervals, MIC(50%), MIC(90%) and the proportion of the sensitive bacterial strains were determined and permitted the following analysis: the activity of cefepime against Gram-negative bacteria was 2 or more times higher than that of cefpirome and amikacin, specially when CIM(90%) was considered; the activity of cefpirome was higher only against E. faecalis. This information must be considered in the rational use of antibiotic, specially in patients with nosocomial infections.

Antifungal activity of propolis on different species of Candida

Propolis is a resinous material collected by bees from the buds or other parts of plants. It is known for its biological properties, having antibacterial, antifungal and healing properties. The antifungal activity of propolis was studied in sensitivity tests on 80 strains of Candida yeasts: 20 strains of Candida albicans, 20 strains of Candida tropicalis, 20 strains of Candida krusei and 15 strains of Candida guilliermondii. The yeasts showed a clear antifungal activity with the following order of sensitivity: C. albicans > C. tropicalis > C. krusei > C. guilliermondii. Patients with full dentures who used a hydroalcoholic propolis extract showed a decrease in the number of Candida.

Padrão de sensibilidade de cepas de Enterobacter spp isoladas na região de Presidente Prudente - SP

Enterobacter spp. are considered important causing agents of infection, specially in hospitalized individuals. The natural resistance of these microorganisms and the great facility to develop resistance to new antimicrobial agents make this genus an important object of study. In this work, 176 strains isolated from various clinical samples were used from hospitalized patients (University Hospital Domingos Leonardo Cerávolo) and from clinic patients (Clinical Laboratory from Unoeste), both situated in Presidente Prudente - SP. E. cloacae (78.9%), E. aerogenes (7.9%) and E. (pantoea) agglomerans (3.9%) were the ones more frequently isolated. Eleven antimicrobial agents were tested by the disk diffusion method and around 90% of the strains presented resistance to the cephalotin, ampicillin and cefaclor. Strains of E. (pantoea) agglomerans presented wide profile of sensibility However one strain of E. cloacae presented resistance to all the antimicrobial agents. The antimicrobial agents with greater inhibitory activity were imipenem and cefepime, for this reason these antimicrobial agents could be the treatment of choice in emergencial therapeutic. This emergencial therapy can be applied with relative security, whereas the data obtained in this study show homogeneity in the profile of sensibility to these antimicrobial agents, independent of the infection site and from the isolated species. The ESBL enzyme could not be detected in no one of the strains by the double diffusion test.

Cryptococcosis outbreak in psittacine birds in Brazil

An outbreak of cryptococcosis occurred in a breeding aviary in São Paulo, Brazil. Seven psittacine birds (of species Charmosyna papou, Lorius lory, Trichoglossus goldiei, Psittacula krameri and Psittacus erithacus) died of disseminated cryptococcosis. Incoordination, progressive paralysis and difficulty in flying were seen in five birds, whereas superficial lesions coincident with respiratory alterations were seen in two birds. Encapsulated yeasts suggestive of Cryptococcus sp. were seen in faecal smears stained with India ink in two cases. Histological examination of the birds showed cryptococcal cells in various tissues, including the beak, choana, sinus, lungs, air sacs, heart, liver, spleen, kidneys, intestines and central nervous system. High titres of cryptococcal antigen were observed in the serum of an affected bird. In this case, titres increased during treatment and the bird eventually died. Yeasts were isolated from the nasal mass, faeces and liver of one bird. Cryptococcus neoformans var. gattii serovar B was identified based on biochemical, physiological and serological tests. These strains were resistant (minimum inhibitory concentration 64 μ g/ml) to fluconazole. This is the first report of C. neoformans var. gattii occurring in psittacine birds in Brazil. © 2004 ISHAM.

Atividade anti Staphylococcus aureus de extratos de própolis (EP) de Apis mellifera preparados com diferentes concentrações de etanol

Propolis has been used in folk medicine and possesses a broad spectrum of biological activities, specially antibacterial activity. Studies have demonstrated that the composition of propolis extract may have influence in such activity. The goal of this study was to investigate the antibacterial activity of eleven propolis extracts (PE) against sixty one Staphylococcus aureus strains, isolated from newborn clinical specimens. The PE from Apis mellifera were prepared by using pure water and mixtures of water with ethanol at different concentrations (from 0 to 100%), 25g of propolis in 100 mL of solvent, and three days of maceration followed by filtration. Determination of Minimal Inhibitory Concentration (MIC) by agar dilution method was performed and serial concentrations from each PE were achieved (%v/v) in plates containing Mueller Hinton agar. It was possible to verify that the anti S. aureus activity was directly proportional to ethanol concentration and no significant differences were observed among PE with ethanol concentration from 70 to 100%. The MIC 90% values ranged from 0.4 to 0.6% (v/v) and the 70% ethanolic extract were the most efficient to inhibit bacterial growth (MIC 90%=0.42%, v/v). In conclusion, our results suggest that the EP composition and, consequently, the concentration of ethanol used as solvent may influence the antibacterial activity of propolis from A. mellifera.

Advances in prodrug design

The background of prodrug design is presented herein as the basis for introducing new and advanced latent systems, taking into account mainly the versatility of polymers and other macromolecules as carriers. PDEPT (Polymer-Directed Enzyme Prodrug Therapy); PELT (Polymer-Enzyme Liposome Therapy); CDS (Chemical Delivery System); ADEPT(Antibody-Directed Enzyme Prodrug Therapy); GDEPT/VDEPT (Gene-Directed Enzyme Prodrug Therapy/Virus-Directed Enzyme Prodrug Therapy); ODDS (Osteotropic Drug Delivery System) and LEAPT (Lectin-directed enzyme-activated prodrug therapy) are briefly described and some examples are given. © 2005 Bentham Science Publishers Ltd.

2,3,4,6-Tetra-O-(3-nitropropanoyl)-O-β-D-glucopyranoside, a new antimicrobial from the roots of Heteropteris aphrodisiaca

A new 2,3,4,6-tetra-O-(3-nitropropanoyl)-O-β-D-glucopyranoside anomer was isolated from the roots of Heteropteris aphrodisiaca and characterized by spectroscopic methods. Activity against Staphylococcus aureus, Bacillus subtilis, Candida albicans, C. parapsilosis, C. krusei, and C. tropicalis was demonstrated.

Analysis of susceptibility profile of Pseudomonas spp. and prevalence of bacterial samples from the surfaces of dental consulting-rooms

The aim of this research was to evaluate the susceptibility profile of Pseudomonas spp. and the prevalence of bacterial samples isolated from horizontal surfaces surrounding wash-basins used by dentists in several adjoined consulting-rooms, at points next to and at a distance from the basin, before and after surgical procedures. Our results showed a high percentage of Gram-positive cocci and Gram-negative bacilli; 34.66% were Staphylococcus spp. and 30.12% were non-fermentative Gram-negative bacilli among which Pseudomonas spp. (40.90%) was the commonest genus. Analysis of the susceptibility profile of Pseudomonas spp. isolates by determining the minimal inhibitory concentration (MIC) of 14 antibiotics showed a great variation among the strains and high rates of resistance to cefazolin, ceftazidime and aztreonan. Of the 14 antibiotics tested, 59.03% were found to be active against all the environmental isolates. Strains were resistant to aztreonan (62.82%), while susceptibility to third generation cephalosporins was variable.