Vancomycin exposure from active calcium sulfate bone filler

Objective: Bone cements and substitutes are commonly used in surgery to deliver antibiotics locally. The objective of this study was to assess the systemic absorption and disposition of vancomycin in patients treated with active calcium sulfate bone filler and to predict systemic concentrations under various conditions. Method: 277 blood samples were taken from 42 patients receiving vancomycin in bone cement during surgery. Blood samples were collected from 3h to 10 days after implantation. Vancomycin was measured by immunoenzymatic assay. Population pharmacokinetic (PK) analysis was performed using NONMEM to assess average estimates and variability of PK parameters. Based on the final model, simulations with various doses and renal function levels were performed. Results: The patients were 64 ± 20 years old, their body weight was 81 ± 22 kg and Cockcroft-Gault creatinine clearance (CLcr) 98 ± 55 mL/min. Vancomycin doses ranged from 200 mg to 6000 mg and implantation sites were hip (n=16), tibia (10) or others (16). Concentration profiles remained low and consistent with absorption rate-limited first-order release, while showing prominent variability. Mean clearance (CL) was 3.87 L/h (CV 35%), absorption rate constant (ka) 0.004 h-1 (66%) and volume of distribution (V) 9.5 L. Simulations with up to 8000 mg vancomycin implant showed systemic concentrations exceeding 20 mg/L for 3.5 days in 43% of the patients with CLcr 15 mL/min, whereas 7% of the patients with normal renal function had a concentration above 20 mg/L for 1.1 days. Subtherapeutic concentrations (0.4-4 mg/L) were predicted during a median of 22 days in patients with normal renal function and 4000 mg vancomycin implant, with limited influence of dose or renal function. Conclusion: Vancomycin-laden calcium sulfate implant does not raise toxicity concern. Selection of resistant bacteria, such as Enterococcus and Staphylococcus species, might however be a concern, as simulations show persistent subtherapeutic systemic concentrations during 3 to 4 weeks in these patients.

Assessment of high hydrostatic pressure and starter culture on the quality properties of low-acid fermented sausages

The addition of starter culture and high pressure processing after ripening improved the microbial quality of low-acid fermented sausages (fuet and chorizo). The use of Lactobacillus sakei CTC6626 and Staphylococcus xylosus CTC6013 as starter culture significantly reduced Enterobacteriaceae and Enterococcus levels in the finished sausages. Moreover, the addition of starter culture produced sausages of similar quality to traditional low-acid fermented sausages. Slightly lower pH values and higher cohesiveness were obtained for both fuet and chorizo with starter culture. Sensory analysis showed no differences between lots of chorizo whereas starter fuet was more acid and gummy. High pressure induced an additional reduction of Enterobacteriaceae in non-starter sausages. An increase of textural properties was observed after pressurization. No other differences were observed between non-treated and pressurized sausages.

Impact of enterococcal colonization and infection in solid organ transplantation recipients from the Swiss Transplant Cohort Study.

BACKGROUND: The burden of enterococcal infections has increased over the last decades with vancomycin-resistant enterococci (VRE) being a major health problem. Solid organ transplantation is considered as a risk factor. However, little is known about the relevance of enterococci in solid organ transplantation recipients in areas with a low VRE prevalence. METHODS: We examined the epidemiology of enterococcal events in patients followed in the Swiss Transplant Cohort Study between May 2008 and September 2011 and analyzed risk factors for infection, aminopenicillin resistance, treatment, and outcome. RESULTS: Of the 1234 patients, 255 (20.7%) suffered from 392 enterococcal events (185 [47.2%] infections, 205 [52.3%] colonizations, and 2 events with missing clinical information). Only 2 isolates were VRE. The highest infection rates were found early after liver transplantation (0.24/person-year) consisting in 58.6% of Enterococcus faecium. The highest colonization rates were documented in lung transplant recipients (0.33/person-year), with 46.5% E. faecium. Age, prophylaxis with a betalactam antibiotic, and liver transplantation were significantly associated with infection. Previous antibiotic treatment, intensive care unit stay, and lung transplantation were associated with aminopenicillin resistance. Only 4/205 (2%) colonization events led to an infection. Adequate treatment did not affect microbiological clearance rates. Overall mortality was 8%; no deaths were attributable to enterococcal events. CONCLUSIONS: Enterococcal colonizations and infections are frequent in transplant recipients. Progression from colonization to infection is rare. Therefore, antibiotic treatment should be used restrictively in colonization. No increased mortality because of enterococcal infection was noted.

Utilização de bactérias ácido-lácticas isoladas do trato intestinal de tilápia-do-nilo como probiótico

O objetivo deste trabalho foi isolar bactérias ácido-lácticas do intestino de tilápias-do-nilo, e avaliar seu potencial probiótico. Foram isoladas cepas de bactérias ácido-lácticas, e foi avaliada a inibição aos patógenos in vitro. As cepas com os melhores resultados foram identificadas e utilizadas no experimento de colonização do trato intestinal de tilápias-do-nilo, via suplementação na dieta, em delineamento inteiramente ao acaso, com três tratamentos e quatro repetições. Foram avaliados: o total de bactérias, as bactérias ácido-lácticas, Vibrio ssp. e Pseudomonas ssp. A cepa com melhor resultado foi utilizada na infecção experimental, em delineamento inteiramente ao acaso, em esquema fatorial 2x3: dieta suplementada com a cepa e dieta-controle; e os peixes não submetidos à injeção, peixes submetidos à injeção de solução salina e à injeção de Enterococcus durans, com três repetições. Foram avaliados os parâmetros hematológicos. As duas cepas identificadas foram: Lactobacillus plantarum e Lactobacillus brevis, que colonizaram o trato intestinal de tilápias, contudo L. plantarum teve menor número total de bactérias e de Pseudomonas ssp. Foi observado maior número total de eritrócitos, trombócitos, leucócitos, linfócitos, neutrófilos e monócitos, em peixes alimentados com L. plantarum e submetidos à injeção de E. durans. O L. plantarum tem efeito probiótico e melhora o sistema imune das tilápias.

In vitro activities of tigecycline combined with other antimicrobials against multiresistant gram-positive and gram-negative pathogens.

OBJECTIVES: To test the activity of tigecycline combined with 16 antimicrobials in vitro against 22 gram-positive and 55 gram-negative clinical isolates. METHODS: Antibiotic interactions were determined by chequerboard and time-kill methods. RESULTS: By chequerboard, of 891 organism-drug interactions tested, 97 (11%) were synergistic, 793 (89%) were indifferent and 1 (0.1%) was antagonistic. Among gram-positive pathogens, most synergisms occurred against Enterococcus spp. (7/11 isolates) with the tigecycline/rifampicin combination. No antagonism was detected. Among gram-negative organisms, synergism was observed mainly with trimethoprim/sulfamethoxazole against Serratia marcescens (5/5 isolates), Proteus spp. (2/5) and Stenotrophomonas maltophilia (2/5), with aztreonam against S. maltophilia (3/5), with cefepime and imipenem against Enterobacter cloacae (3/5), with ceftazidime against Morganella morganii (3/5), and with ceftriaxone against Klebsiella pneumoniae (3/5). The only case of antagonism occurred against one S. marcescens with the tigecycline/imipenem combination. Selected time-kill assays confirmed the bacteriostatic interactions observed by the chequerboard method. Moreover, they revealed a bactericidal synergism of tigecycline with piperacillin/tazobactam against one penicillin-resistant Streptococcus pneumoniae and with amikacin against Proteus vulgaris. CONCLUSIONS: Combinations of tigecycline with other antimicrobials produce primarily an indifferent response. Specific synergisms, especially against enterococci and problematic gram-negative isolates, might be worth investigating in in vitro models and/or in animal models simulating the human environment.

Haja-asutusalueiden sakokaivolietteiden kalkkistabilointi ja hyötykäyttö maataloudessa

In the sparsely populated areas of Finland there are approximately 350 000 households and 450 000 leisure time residences outside sewer networks. According to the Finnish domestic wastewater act outside sewer networks, the Finnish Government is reducing the environmental load of domestic wastewaters by the year 2017. The law is aimed at restricting the quality of sludge from domestic wastewater purification systems. The wastewater purification systems are complex systems, which often include sedimentation basins. The sedimentation basins remove most of the nutrients from the domestic wastewaters. The Finnish Government has decided that sedimentation basin sludge must be treated before reusing. One possibility is to stabilise domestic sludge with slaked lime and to reuse treated sludge in agriculture. According to this master’s thesis lime stabilisation can be done in sedimentation basins or in decanting tanks. Decanting tanks must be under 100 m3. Dosage of stabilisation is 8,5 kg/m3 of lime. If you are treading sludge that is highly hydrous, you need 13,5 kg/m3 of lime. In stabilisation lime and sludge must be thoroughly mixed. Mixed sludge must be in sedimentation basin at least two hours. If there is evidence that sludge contains salmonella or if it’s decanting tank stabilisation time is 48 hours. Sludge must be mixed at least once during the longer stabilisation time. Lime destroys Esherichia coli and enterococcus concentrations below accepted level. Lime also destroys Salmonella bacterium. After treating, sludge’s can be distributed over a field. You can safely spread lime treated domestic sludge’s about 40 m3/ha. Lime stabilisation can also be used to treat separately and collectively collected domestic wastewaters.

Aporphine alkaloids from Ocotea macrophylla (Lauraceae)

Four aporphine alkaloids from the wood of Ocotea macrophylla (Lauraceae) were isolated and characterized as (S)-3-methoxy-nordomesticine (1), (S)-N-ethoxycarbonyl-3-methoxy-nordomesticine (2), (S)-N-formyl-3-methoxy-nordomesticine (3) and (S)-N-methoxycarbonyl-3-methoxy-nordomesticine (4); alkaloids 2-4 are being report for the first time. The structure the isolated compounds were determined based on their spectral data and by comparison of their spectral data with values described in literature. The alkaloid fraction and compound 1 showed antifungal activity against Fusarium oxysporum f. sp. lycopersici and also compound 1 showed antimicrobial activity towards Staphylococcus aureus, Enterococcus faecalis as well.

Alcaloides isoquinolínicos e investigação das atividades antiplasmódica e antibacteriana de Guatteria citriodora (Annonaceae)

Phytochemical investigations of the stem bark, leaves and twigs of Guatteria citriodora resulted in the isolation of eight alkaloids: liriodenine, lysicamine, O-methylmoschatoline, 3-methoxyoxoputerine, palmatine, 3-methoxyguadiscidine, guattescidine and oxoputerine. The structures of the isolated substances were established by extensive spectroscopic techniques (1D and 2D NMR) and mass spectrometry (MS), as well as by comparison with data reported in the literature. The in vitro antimalarial activity of the alkaloidal fractions of the leaves and twigs against Plasmodium falciparum FCR3 showed significant results, with IC50 = 1.07 and 0.33 mg mL-1, respectively. The alkaloidal fraction of the leaves showed moderate activity against Enterococcus faecalis, with IC50 = 125.0 mg mL-1. Antiplasmodial and antibacterial activities are attributed to alkaloidal constituents.

Phytochemical investigation of Wissadula periplocifolia (L.) C. Presl and evaluation of its antibacterial activity

A phytochemical study on the aerial parts of Wissadula periplocifolia using chromatographic techniques has led to the isolation of sitosterol (1a), stigmasterol (1b), sitosterol 3-O-β-D-glucopyranoside (2a), stigmasterol 3-O-β-D-glucopyranoside (2b), phaeophytin A (3), 13²-hydroxy-(13²-S)-phaeophytin A (4), phaeophytin B (5), 17³-ethoxyphaeophorbide (6), 3,4-seco-urs-4(23),20(30)-dien-3-oic acid (7), 3-oxo-21β-H-hop-22(29)-ene (8), dammaradienone (9a), and taraxastenone (9b). The isolated compounds were characterised by spectroscopic analysis. A preliminary assay to evaluate the antibacterial activity of W. periplocifolia extracts and fractions showed that the dichloromethane, ethyl acetate, and n-butanol fractions were active against Enterococcus faecalis.

Óleos essenciais de uvaia (Eugenia pyriformis Cambess): avaliação das atividades microbiana e antioxidante

A geração de radicais livres, resultado dos processos metabólicos necessários para a produção de energia, causam um grande número de doenças, o que aumenta o interesse pelos compostos antioxidantes presentes em frutos e vegetais e que são responsáveis pela captura destes radicais. Além disso, a aplicação de óleos e extratos de frutos no controle microbiológico justifica o crescimento dos estudos científicos dessas matérias-primas. Nesse contexto o presente trabalho analisou o óleo essencial de diferentes partes do fruto de uvaia (Eugenia pyriformis) em relação à atividade microbiológica, fenóis totais e antioxidantes. O óleo essencial apresentou rendimento maior na casca (1,23 %), seguido pela fração casca com polpa, a fração com menor rendimento foi à semente, sendo quantificados a partir do fruto refrigerado. Os resultados obtidos na microbiologia frente as cepas de Scherichia coli ATCC25922, Staphylococcus aureus ATCC 6538, Pseudomonas aeruginosas ATCC 27 853 e Enterococcus faecalis ATCC99212 foram de ação bacteriostática em todas as cepas testadas, exceto a bactéria P. aeruginosas. Intervalo de inibição superior a 24 h foi observado para o óleo essencial da casca frente a bactéria P. aeruginosas. A quantificação de fenóis totais não foi possível pois os valores médios encontrados foram inferiores ao LQ (5 μg/mL), por espectrofotometria a 760 nm e as atividade antioxidante mostraram-se não significativas nas concentrações analisadas, em todas as frações.

ISOLAMENTO E CARACTERIZAÇÃO DE BACTÉRIAS SOLUBILIZADORAS DE FOSFATO DA RIZOSFERA DE Eucalyptus sp.1

RESUMO A inoculação de micro-organismos solubilizadores de fosfato, em conjunto ou não com fungos micorrízicos, pode ser alternativa para a redução dos custos de produção de eucalipto por meio da diminuição dos gastos com fertilizantes fosfatados. Dessa forma, objetivou-se com este trabalho isolar e caracterizar bactérias solubilizadoras de fosfato da rizosfera de Eucalyptussp., visando à sua coinoculação com fungos ectomicorrízicos. Entre os 24 isolados de bactérias originários do solo rizosférico de eucalipto, 12 são do filo γ-Proteobacteria e pertencentes à família Enterobacteriaceae (Enterobacter, Kluyvera e Klebsiella); 9 do filo β-Proteobacteria (Burkholderia); 1 do filo Actinobacteria (Curtobacterium); e 1 do filo Firmicutes (Enterococcus). O índice de solubilização de fosfato, calculado dividindo-se o diâmetro do halo de clareamento pelo diâmetro da colônia, variou de 0 a 11, sendo Enterococcus avium a espécie com o maior potencial de solubilização de CaHPO4in vitro. A produção de acidez em meio glicose-extrato de levedura pelos isolados bacterianos rizosféricos foi significativa, no entanto a capacidade de solubilização de CaHPO4 não se correlacionou com a acidificação do meio. Alguns isolados bacterianos promoveram forte inibição do crescimento de Pisolithus sp., isolado H4111, enquanto outros não causaram esse fenômeno. Os isolados RE 56 (Enterococcus avium), RE 41 (Burkholderia cepacea), RE 52 e RE 30 (ambos Burkholderia pyrrocinia) foram aqueles que apresentaram maior potencial para utilização em experimentos de coinoculação com fungos ectomicorrízicos.

Colonização bacteriana do canal cervical em gestantes com trabalho de parto prematuro ou ruptura prematura de membranas

OBJETIVO: estudar a colonização bacteriana do canal cervical em gestantes com trabalho de parto prematuro ou com ruptura prematura de membranas. MÉTODOS: foram avaliadas 212 gestantes com trabalho de parto prematuro ou ruptura prematura de membranas. Na admissão hospitalar foram coletadas duas amostras do conteúdo endocervical e realizadas bacterioscopia e cultura em meios ágar sangue e ágar chocolate. Foram analisadas associações da colonização endocervical com infecção do trato urinário materno, corioamnionite, utilização de antibióticos, sofrimento fetal, prematuridade e infecção e óbito neonatais. RESULTADOS: a prevalência de colonização endocervical foi 14,2% (IC95%=9,5-18,9%), com resultados similares entre os casos com trabalho de parto prematuro ou ruptura prematura de membranas. O microorganismo mais prevalente na população estudada foi o estreptococo do grupo B (9,4%), sendo também isolados Candida sp, Streptococcus sp, Streptococcus pneumoniae, Escherichia coli e Enterococcus sp. Das bacterioscopias analisadas, os achados mais freqüentes foram baixa prevalência de bacilos de Döderlein e elevado número de leucócitos. Em mulheres colonizadas, houve maior prevalência de infecção do trato urinário (23,8 versus 5,4%; p<0,01), infecção neonatal (25,0 versus 7,3%; p<0,01) e óbito neonatal (dois casos entre as colonizadas; p<0,02), quando comparadas às não colonizadas. CONCLUSÕES: observou-se alta prevalência de colonização endocervical, mesmo sem a utilização de meios de cultura seletivos. O estreptococo do grupo B foi o principal microorganismo isolado, reforçando a necessidade de triagem deste agente na gestação. Um terço das culturas positivas ocorreram por outros agentes. Estudos complementares são necessários para esclarecer a importância destes achados bacteriológicos no canal endocervical e sua associação com complicações gestacionais, sepse e mortalidade neonatais.

Prevalência de sorovares de Salmonella isolados de aves no Brasil

Foram caracterizadas antigenicamente amostras de Salmonella isoladas de aves (portadoras e doentes) provenientes de diversas regiões do país durante o período de 1962 a 1991. Nas 2123 culturas analisadas foram reconhecidos 90 sorovares, distribuídos em 14 sorogrupos com predominância dos grupos O:9 (40,0%), O:4 (33,3%), O:7 (10,6%) e O: 3,10 (6,7%). A maior diversidade de sorovares foi reconhecida no sorogrupo O:7 com 22 tipos distintos, secundado por O:4, O:3,10 e O:9, constituídos de 19, 15 e 10 sorotipos, respectivamente. No computo geral, foi determinada a média de 10,8 sorovares isolados por ano. Os sorovares classificados como muito frequentes nos três decênios, representando 65 a 67%, dos isolamentos, foram S. Gallinarum, S. Pullorum, S. Typhimurium, S. Heidelberg, S. Enteritidis e S. Infantis. Considerações de natureza bacteriológica e epidemiológica foram discutidas em relação a alguns dos sorotipos prevalentes.

IgA production, coliforms analysis and intestinal mucosa morphology of piglets that received probiotics with viable or inactivated cells

Two types of probiotics were used in piglets. One product is a mixed culture of viable Lactobacillus acidophilus, Enterococcus faecium e Bifidobacterium bifidum. The second product is composed of inactivated Lactobacillus acidophilus cells. The piglets received two weekly oral doses for 30 days while a control group did not receive probiotics. All piglets were euthanized at the 30th day of life and the mesenteric lymph nodes, the small intestine, and blood samples were collected. The tissue samples were studied by light microscopy and the blood serum was analyzed by ELISA method. The treatment with the probiotic with viable cells produced higher serum levels of IgA (P<0.05) and more IgA expressing cells were found in the mesenteric lymph nodes than observed in the inactivated cells treatment or control groups (P<0.05). Also, intestinal villi were longer, crypts were deeper (P<0.05) and fecal coliform count was lower than found in the inactivated product (P<0.05). These results suggest that viable probiotics are more efficient than inactivated probiotics to induce immunostimulation and intestinal modifications in piglets, thus improving their health and development.

Hematological and immunological responses of Nile tilapia after polyvalent vaccine administration by different routes

The efficacy of a polyvalent bacterin vaccine against Aeromonas hydrophila, Pseudomonas aeroginosa and Enterococcus durans administered by different routes in Nile tilapia was assessed by analyzing hematological and immunological parameters 7 and 21 days after vaccination. Treatments consisted of: non-vaccinated tilapia; tilapia vaccinated by intraperitoneal injection with 2x10(8) formalin-inactivated bacteria·mL-1; tilapia vaccinated orally with 2x10(7) formalin-inactivated bacteria·g-1, feed for 5 days; tilapia vaccinated by immersion bath in 2x10(7) formalin-inactivated bacteria·mL-1, for 20 minutes. Vaccinated fish groups presented higher hematocrit, number of erythrocytes and leukocytes than the non-vaccinated group. Serum agglutination titer of intraperitoneally vaccinated fish was higher on both evaluation periods for the three bacteria strains. Only on day 21 post-vaccination fish from the oral and immersion vaccination groups presented higher serum agglutination titer than the non-vaccinated fish for A. hidrophyla and E. durans. Serum antimicrobial activity in vaccinated fish was higher for P. aeroginosa and E. coli than in non-vaccinated fish on both evaluation periods. The different vaccine administration routes stimulated hematological and immunological responses in Nile tilapia 21 days post-vaccination, but intraperitoneal vaccination presented higher total number of leukocytes, lymphocytes and serum agglutination titer.