Genetic similarity between staphylococcus sp isolated from human and hospital settings, and susceptibility to different antimicrobials

Foram coletadas 143 amostras de mãos de humanos e camas hospitalares, através de swabs no caldo BHI, em um hospital escola da cidade de Ribeirão Preto/SP. As amostras coletadas foram incubadas a 37ºC por 24 horas e após este período as culturas foram semeadas em placas de Petri contendo agar Staphylococcus Médium 110. As colônias típicas do gênero Staphylococcus foram colhidas e estocados a 4ºC até o momento de elaboração das provas de catalase, manitol, hemólise, DNAse e coagulase. As cepas isoladas foram analisadas através da técnica de RAPD-PCR para verificar o grau de similaridade. A sensibilidade das cepas isoladas foi testada frente a 10 diferentes antibióticos. Das 92 cepas de Staphylococcus sp isoladas, 67 (72,8%) foram identificados como Staphylococcus coagulase-negativas e 25 (27,2%) como Staphylococcus coagulase-positivas. A análise de similaridade mostrou uma grande heterogeneidade entre as cepas, entretanto foram isoladas algumas cepas com 100% de similaridade. Resistência a oxacilina foi encontrada em 39 (42%) cepas. Duas cepas de estafilococos coagulase-negativos mostraram-se resistentes a vancomicina. Onze cepas (12%) de estafilococos foram consideradas multirresistentes. Medidas de desinfecção das mãos de pessoal e dos leitos hospitalares e a racionalização do uso indiscriminado de antibióticos podem contribuir para a queda da transmissão de patógenos e diminuição da pressão de seleção, e conseqüentemente diminuindo a freqüência e letalidade das infecções nosocomiais.

Factors predictive of inappropriateness in requests for parenteral antimicrobials for therapeutic purposes: A study in a small teaching hospital in Brazil

Background: The identification of patterns of inappropriate antimicrobial prescriptions in hospitals contributes to the improvement of antimicrobial stewardship programs (ASP). Methods: We conducted a cross-sectional study to identify predictors of inappropriateness in requests for parenteral antimicrobials (RPAs) in a teaching hospital with 285 beds. We reviewed 25% of RPAs for therapeutic purposes from y 2005. Appropriateness was evaluated according to current guidelines for antimicrobial therapy. We assessed predictors of inappropriateness through univariate and multivariate models. RPAs classified as 'appropriate' or 'probably appropriate' were selected as controls. Case groups comprised inappropriate RPAs, either in general or for specific errors. Results: Nine hundred and sixty-three RPAs were evaluated, 34.6% of which were considered inappropriate. In the multivariate analysis, general predictors of inappropriateness were: prescription on week-ends/holidays (odds ratio (OR) 1.67, 95% confidence interval (CI) 1.20-2.28, p = 0.002), patient in the intensive care unit (OR 1.57, 95% CI 1.11-2.23, p = 0.01), peritoneal infection (OR 2.15, 95% CI 1.27-3.65, p = 0.004), urinary tract infection (OR 1.89, 95% CI 1.25 -2.87, p = 0.01), combination therapy with 2 or more antimicrobials (OR 1.72, 95% CI 1.15-2.57, p = 0.008) and prescriptions including penicillins (OR 2.12, 95% CI 1.39-3.25, p = 0.001) or 1(st) generation cephalosporins (OR 1.74, 95% CI 1.01-3.00, p = 0.048). Previous consultation with an infectious diseases (ID) specialist had a protective effect against inappropriate prescription (OR 0.34, 95% CI 0.24-0.50, p < 0.001). Factors independently associated with specific prescription errors varied. However, consultation with an ID specialist was protective against both unnecessary antimicrobial use (OR 0.04, 95% CI 0.01-0.26, p = 0.001) and requests for agents with an insufficient antimicrobial spectrum (OR 0.14, 95% CI 0.03-0.30, p = 0.01). Conclusions: Our results demonstrate the importance of previous consultation with an ID specialist in assuring the quality of prescriptions. Also, they highlight prescription patterns that should be approached by ASP policies.

Transference in vitro of the resistance to the antimicrobials between Escherichia coli, Lactobacillus spp. and Salmonella enteritidis isolated from chickens

O objetivo deste trabalho foi verificar a possibilidade de transferência de resistência aos antimicrobianos entre bactérias normais da microbiota de frangos e Salmonella Enteritidis. Utilizamos amostras de Lactobacillus spp. (L. spp.), Salmonella Enteritidis (SE) e Escherichia coli (E. coli) previamente isolados de frangos, selecionados após prova de sensibilidade antimicrobiana in vitro conforme metodologia padrão (Comitê Nacional para Padrões Clínicos de Laboratório). Utilizamos aqueles com resistência e sensibilidade aos antimicrobianos indutores, chamados de bactérias doadoras e receptoras, respectivamente. Os antimicrobianos indutores foram utilizados para estimular a transferência de resistência aos antimicrobianos entre as bactérias. A possibilidade de transferência foi verificada da E. coli resistente para a SE e L. spp. Também foi verificada a transferência de uma amostra de L. spp resistente aos antimicrobianos indutores para a SE. Só foi possível verificar a transferência da resistência aos antimicrobianos indutores quando a bactéria doadora foi a E. coli e a bactéria receptora foi a SE. No presente estudo concluímos que a transferência de resistência aos antimicrobianos entre bactérias é possível, mas nem todas as bactérias participam desse evento, não transmitindo e nem adquirindo esta resistência.

Rational use of antimicrobials in dentistry during pregnancy

The use of medicines during pregnancy deserves special attention from dentists due to the potential risks to fetal development. The prescription of antimicrobial drugs during this period must be based not only on the etiology of the disease but also on the drug's effect on the embryo, which may be toxic, possibly leading to irreversible lesions. Interest in studies of the teratogenic effects of drugs increased in response to reports of the high incidence of phocomelia in patients treated with thalidomide. Although teratogenicity has long been known, pregnant women today are still exposed to this risk. The effects of drugs depend on the level of susceptibility of the fetus and on the period of exposure during pregnancy. In this context, and considering the paucity of studies on this subject in dentistry, the aim of this review was to offer an up-to-date compilation of data on the antimicrobial drugs most frequently used during pregnancy and the effects of their use.

Modified E-test by the addition of EDTA-Tris and dimethyl sulfoxide on the potentiation of the effects of some antimicrobials in Pseudomonas aeruginosa strains isolated from bovine mastitis

A concentração inibitória mínima-MIC em 30 estirpes de Pseudomonas aeruginosa isoladas de mastite bovina foi avaliada utilizando o E-test padrão e o método modificado, pela adição de Tris-EDTA e DMSO. Os métodos modificados apresentaram redução significativa da MIC das estirpes utilizando a gentamicina, a ciprofloxacina e a norfloxacina.

Staphylococcus aureus: Resistance patterns to antimicrobials and Penicillinase among strains isolated from apparently healthy lactating cows

Ninety-two strains of Staphylococcus aureus isolated from the nasal fossa and udder skin of apparently healthy lactating cows were analyzed for resistance to antibiotics and production of penicillinase.The results showed a greater frequency of resistance patterns to penicillin and ampicillin.All strains were sensitive to oxacyllin and gentamicin.The most frequent Barber and Burston model was SSSS (60.90%), followed by RSSS (18.50%).With respect to the production of penicillinase although the Lucas method indicated a larger number of positive samples, we suggest the use of the Haight and Finland method due to a greater consistency of data obtained with it.

The inhibition of 5-enolpyruvylshikimate-3-phosphate synthase as a model for development of novel antimicrobials

EPSP synthase (EPSPS) is an essential enzyme in the shikimate pathway, transferring the enolpyruvyl group of phosphoenolpyruvate to shikimate-3-phosphate to form 5-enolpyruvyl-3-shikimate phosphate and inorganic phosphate. This enzyme is composed of two domains, which are formed by three copies of βαβαββ-folding units; in between there are two crossover chain segments hinging the nearly topologically symmetrical domains together and allowing conformational changes necessary for substrate conversion. The reaction is ordered with shikimate-3-phosphate binding first, followed by phosphoenolpyruvate, and then by the subsequent release of phosphate and EPSP. N-[phosphomethyl]glycine (glyphosate) is the commercial inhibitor of this enzyme. Apparently, the binding of shikimate-3-phosphate is necessary for glyphosate binding, since it induces the closure of the two domains to form the active site in the interdomain cleft. However, it is somehow controversial whether binding of shikimate-3-phosphate alone is enough to induce the complete conversion to the closed state. The phosphoenolpyruvate binding site seems to be located mainly on the C-terminal domain, while the binding site of shikimate-3-phosphate is located primarily in the N-terminal domain residues. However, recent results demonstrate that the active site of the enzyme undergoes structural changes upon inhibitor binding on a scale that cannot be predicted by conventional computational methods. Studies of molecular docking based on the interaction of known EPSPS structures with (R)- phosphonate TI analogue reveal that more experimental data on the structure and dynamics of various EPSPS-ligand complexes are needed to more effectively apply structure-based drug design of this enzyme in the future. © 2007 Bentham Science Publishers Ltd.

Contamination of cattle carcasses by Escherichia coli shiga like toxin with high antimicrobials resistence

During processing of cattle carcasses, contamination may occurs with the transfer of microbiota of animals feaces to carcasses. This contamination many times may be by Escherichia coli carriers of virulence factor as stx and eae genes being classified as Shiga like toxin. Shiga toxin-producing Escherichia coli (STEC) is recognized wordwide as human pathogen. A survey was performed to determine the sensibility profile to several antimicrobial drugs of STEC in carcasses obtained from an abattoir in Brazil between March 2008 and August at 2009. A total of 120 STEC were isolated. All isolates were confirmed as being E. coli by their biochemical analysis and submitted to polymerase chain reaction (PCR) for detection of stx, eae and ehly genes. No strains was isolated being carriers of ehly gene. The number of isolates carriers of eae gene were 48/120. The most frequent resistance was seen against cephalothin (84.0%), streptomycin (45.0%), nalidixic acid (42.0%) and tetracycline (20.0%). Multidrug resistance (MDR) to three or more antimicrobial agents was observed in 46 (38.3%) E. coli isolates. The findings of STEC and MRD show that cattle carcasses may be a reservoir of pathogenic bacterial for the consumer public. © 2011 Academic Journals.

Effect of natural antimicrobials on microbiological and sensorial quality of fresh-cut cantaloupe melon

The effect of different natural antimicrobials on the microbiological and sensorial quality of fresh-cut Cantaloupe melons stored up to 10 days at 5°C was examined. Pieces of melon were washed for 1 min at 5ºC in water (control), vanillin (1000 mg/L and 2000 mg/L) or cinnamic acid (148.16 mg/L and 296.32 mg/L). Other antimicrobial treatments consisted of packaging the pieces of melon with an antimicrobial pad which contained cinnamic acid (148.16 mg/L and 296.32 mg/L). After 10 days of storage, significant differences among antimicrobials treatments and water treatment were found. In water treatment, the psychrotroph load was 3.63 ± 0.09 log cfu g-1 meanwhile on all antimicrobial treatments the values ranged from 3.04 ±0.13 log cfu g-1 to 3.28±0.1 log cfu g-1. Mesophilic growth in the control treatment averaged 6.79±0.06 log cfu g-1 meanwhile on antimicrobial treatments the counts were from 5.15±0.01 log cfu g-1 to 5.30±0.03 log cfu g-1. Total coliform levels were 7.8±0.1 log cfu g-1 when melon was washed in water, followed by washing with cinnamon (296.32 mg/L) at 6.5 log cfu g-1 and for the rest of the treatments were around 5.5 log cfu g-1. The treatments did not display differences among mould and yeast growth after 10 days of storage. The sensorial quality decreased throughout storage. However, at the end of storage, the scores ranged between 6.5 and 7, above the minimum level for marketability (level 5). Sensorial panelist noted a ‘sweet’ taste when vanillin was used as sanitizer. In all antimicrobial treatments, no relation was found between a higher dose and a higher microbial reduction. So, vanillin at 1000 mg/L in water or cinnamic acid at 148.16 mg/L provided in water dip or as a pad inside the trays could be optimal natural sanitizers to substitute the use of chlorine in fresh-cut products as Cantaloupe melon.

Antimicrobial resistance of heterotrophic marine bacteria isolated from seawater and sands of recreational beaches with different organic pollution levels in southeastern Brazil: evidences of resistance dissemination

Antimicrobial resistance of marine heterotrophic bacteria to different antimicrobials agents were evaluated in seawater, dry and wet sands from three marine recreational beaches with different pollution levels. In all studied beaches, the greatest frequencies of resistance were found in relation to penicillin. on Gonzaguinha, the most polluted beach, 72.3% of all isolated strains showed simple resistance, whilst 8.33% had multiple resistance. The values found on Ilha Porchat beach, were 70.8% and 6.9% for simple and multiple resistances, respectively. on GuaraA(0), the less polluted beach, only 35.3% of isolated strains had simple resistance. Multiple resistance was not observed. While samples from Gonzaguinha and Ilha Porchat beach showed isolated strains resistant to seven and six different antimicrobial agents, respectively, samples from GuaraA(0) beach were resistant only to penicillin and erytromicin. The positive correlations obtained between the degree of seawater contamination and frequency and variability of bacterial resistance indicate that polluted marine recreational waters and sands are sources of resistant bacteria contributing thus, to the dissemination of bacterial resistance.

Antimicrobial resistance and species composition of Enterococcus spp. isolated from waters and sands of marine recreational beaches in Southeastern Brazil

Density, species composition and antimicrobial resistance in bacteria of the Enterococcus genus were evaluated in seawater and sands from 2 marine recreational beaches with different levels of pollution. The 2 beaches showed predominance of Enterococcus faecalis and Enterococcus faecium, in the water and the sand. Dry sand presented higher densities of Enterococcus sp. and higher frequency of resistant strains than wet sand and seawater. The beach with a higher degree of pollution presented higher percentages of resistant strains (66.7% and 61.5%, in sand and in water, respectively) and resistance to a larger number of antimicrobials compared with the less polluted beach, Ilha Porchat (35.7% and 31.25% of resistant strains in sand and water, respectively). in water samples, the highest frequencies of resistance were obtained against streptomycin (38.5%) and erythromycin (25%), whilst in sand, the highest frequencies were observed in relation to erythromycin and tetracycline (38.1% and 14.3%, respectively). These results show that water and sands from beaches with high indexes of faecal contamination of human origin may be potential sources of contamination by pathogens and contribute to the dissemination of bacterial resistance. (C) 2007 Elsevier Ltd. All rights reserved.

Prevalence and antimicrobial resistance patterns of methicillin-resistant staphylococci (MRS) isolated in a Veterinary Teaching Hospital in Brazil

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Shiga Toxigenic and Atypical Enteropathogenic Escherichia coli in the Feces and Carcasses of Slaughtered Pigs

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

New antimicrobial therapies used against fungi present in subgingival sites-A brief review

Although the main reservoir of Candida spp. is believed to be the buccal mucosa, these microorganisms can coaggregate with bacteria in subgingival biofilm and adhere to epithelial cells. The treatment of periodontal disease includes scaling and root planning (SR?) associated with proper oral hygiene. However, some patients may have negative responses to different therapeutic procedures, with a continuous loss of insertion, so the use of antimicrobials is needed as an adjuvant to SRP treatment. The use of a broad-spectrum antibiotic, such as tetracycline and metronidazole, as an aid in periodontal treatment has also been a factor for the development of superinfections by resistant bacteria and Candida species, even in patients with HIV. In the dental practice, the most commonly used antifungals are nystatin and fluconazole. However, the introduction of new drugs like the next generation of azoles is essential before the onset of emergent species in periodontal disease. Plants are good options for obtaining a wide variety of drugs. This alternative could benefit a large population that uses plants as a first treatment option. Plants have been used in medicine for a long time and are extensively used in folk medicine, because they represent an economic alternative, are easily accessible and are applicable to various diseases. Herein, we briefly review the literature pertaining the presence of Candida sp. in periodontal pockets, the conventional antifungal resistance and new therapies that include natural antifungal agents are reviewed. (C) 2011 Elsevier Ltd. All rights reserved.