Antimicrobial and antileishmanial activities of diterpenoids isolated from the roots of salvia deserta

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Multirresistência microbiana e opções terapêuticas disponíveis

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Development and validation of a stability-indicative agar diffusion assay to determine the potency of flucloxacillin sodium in capsules

Flucloxacillin sodium (FLU) is a semi-synthetic penicillin active against many gram-positive bacteria such as streptococci and penicilinase-producing staphylococci, including methicillin-susceptible S. aureus. This study describes the development and validation of a microbiological assay, applying the diffusion agar method for the determination of FLU, as well as the evaluation of the ability of the method in determining the stability of FLU in capsules against acidic and basic hydrolysis, photolytic and oxidative degradations, using S. aureus ATCC 25923 as micro-organism test and 3 x 3 parallel line assay design (three doses of the standard and three doses of the sample in each plate), with six plates for each assay, according to the Brazilian Pharmacopoeia. The validation method showed good results including linearity, precision, accuracy, robustness and selectivity. The assay is based on the inhibitory effect of FLU using Staphylococcus aureus ATCC 25923. The results of the assay were treated by analysis of variance (ANOVA) and were found to be linear (r = 0.9997) in the range from 1.5 to 6.0 μg/mL, precise (repeatability: R.S.D. = 1.63 and intermediate precision: R.S.D. = 1.64) and accurate (98.96%). FLU solution (from the capsules) exposed to direct UVC light (254 nm), alkaline and acid hydrolysis and hydrogen peroxide causing oxidation were used to evaluate the specificity of the bioassay. Comparison of bioassay and liquid chromatography by ANOVA showed no difference between methodologies. The results demonstrated the validity of the proposed bioassay, which is a simple and useful alternative methodology for FLU determination in routine quality control.

Epidemiologia molecular e estudo dos fatores de virulência de Staphylococcus aureus resistentes à oxacilina isolados de feridas em pacientes atendidos em unidades básicas de saúde da cidade de Botucatu

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

Epidemiologia da colonização e infecção microbiana em Unidade de Terapia Intensiva Neonatal: abordagem clínica e molecular

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

Etiolofia, epidemiologia e prognóstico das pneumonias associadas à ventilação mecânica em um hospital de ensino, com ênfase no estudo molecular e virulência de Staphylococcus aureus

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Etiolofia, epidemiologia e prognóstico das pneumonias associadas à ventilação mecânica em um hospital de ensino, com ênfase no estudo molecular e virulência de Staphylococcus aureus

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Performance of surveillance cultures at different body sites to identify asymptomatic Staphylococcus aureus carriers

The objective was to evaluate the performance of surveillance cultures at various body sites for Staphylococcus aureus colonization in pregnant women and newborns (NB) and the factors associated with nasal colonization. For NB, 4 sites were evaluated: nares, oropharynx, perineum, and umbilical stump (birth, third day, and weekly). For pregnant women, 4 sites during labor: anterior nares, anus, perineum, and oropharynx. Nasally colonized patients were compared with colonized only extranasally. Colonization was 53% of 392 pregnant women (methicillin-resistant S. aureus [MRSA]: 4%) and 47% of 382 NB (MRSA: 9%). For newborn patients, the best body site was the umbilical stump (methicillin-susceptible S. aureus [MSSA]: 64%; MRSA: 68%) and the combination of nares + umbilical (MSSA: 86%; MRSA: 91%). Among pregnant women, the best body site was the anterior nares (MSSA: 59%; MRSA: 67%) and the combination of nares + oropharynx (MSSA: 83%; MRSA: 80%). A smaller number of household members were associated with MRSA carriage in pregnant women (2.2 +/- 0.6 versus 3.6 +/- 1.8; P = 0.04). In conclusion, multiple culture sites are needed. Control programs based on surveillance cultures may be compromised. (C) 2012 Elsevier Inc. All rights reserved.

Estágio Sanduiche na Noruega: relato de experiência

O Programa de Doutorado no Brasil com Estágio no Exterior, conhecido como Doutorado Sanduíche, visa a contribuir para intercâmbios dos cursos de Pós-Graduação no País com seus congêneres no exterior. O objetivo deste artigo foi relatar a experiência vivida durante o estágio realizado na Noruega, em unidades hospitalares, laboratórios de microbiologia, órgãos federais e serviços de saúde de Oslo e Região Metropolitana. Foram desenvolvidas atividades de vigilância epidemiológica, técnicas laboratoriais de identificação e tipagem molecular de Staphylococcus aureus e políticas públicas e institucionais de prevenção e controle dessas bactérias, quando multirresistentes. O estágio, além de subsidiar e fortalecer a análise dos dados do projeto da tese, permitiu refletir sobre a importância de políticas públicas e diretrizes definidas, e fornecer condições para ações de prevenção e controle de agravos, tendo a saúde e o bem-estar da pessoa como valores de Estado.

Timing per l'inserimento in lista dei pazienti affetti da fibrosi cistica che necessitano di trapianto polmonare: casistica di un centro regionale di riferimento

Timing of waiting list entrance for patients with cystic fibrosis in need of pulmonary transplant: the experience of a regional referral centre Objective: Evaluation of parameters that can predict a rapid decay of general conditions of patients affected by Cystic Fibrosis (CF) with no specific criteria to be candidate to pulmonary transplant. Material and methods: Fifteen patients with CF who died for complications and 8 who underwent lung transplantation in the 2000-2010 decade, were enrolled. Clinical data 2 years before the event (body max index, FEV1%, number of EV antibiotic treatments per year, colonization with Methicillin-resistant Staphylococcus aureus (MRSA), pseudomonas aeruginosa mucosus, burkholderia cepacia, pulmonary allergic aspergilosis) were compared among the 2 groups. Results: Mean FEV1% was significantly higher and mean number of antibiotic treatment was lower in deceased than in the transplanted patients (p<0.002 and p<0.001 respectively). Although in patients who died there were no including criteria to enter the transplant list 2 years before the exitus, suggestive findings such as low BMI (17.3), high incidence of hepatic pathology (33.3%), diabetes (50%), and infections with MRSA infection (25%), Pseudomonas aeruginosa (83.3%) and burkholderia cepacia (8.3%) were found with no statistical difference with transplanted patients, suggesting those patients were at risk of severe prognosis. In patients who died, females were double than males. Conclusion: While evaluating patients with CF, negative prognostic factors such as the ones investigated in this study, should be considered to select individuals with high mortality risk who need stricter therapeutical approach and follow up. Inclusion of those patients in the transplant waiting list should be taken into account.

Saccharide based nanocapsules - From monomer building blocks to improved capsules properties

In dieser Arbeit wurde der vielfältige Nutzen von Kohlenhydraten in Nanokapsel Systemen untersucht. Drei verschiedene Nanokapsel-Typen wurden durch Reaktion an der Grenzfläche von inversen Miniemulsionen hergestellt. Es wurde gezeigt, dass die Kohlenhydrate nach Modifizierung als Monomer an der Kapselbildung teilnehmen können, oder zur Erhöhung der Sensitivität eines verkapselten Kontrastmittels beitragen können. Im Folgenden werden die Ergebnisse der einzelnen Projekte zusammengefasst. Eine neuartige Grenzflächen-Synthese zur Herstellung von Nanokapseln wurde entwickelt und untersucht. Bei der Reaktion handelt es sich um eine Ruthenium katalysierte Olefin-Kreuzmetathese, welche für die Reaktion an der Grenzfläche angepasst wurde. Als wasserlösliches Macromonomer wurde Dextranacrylat synthetisiert. Der Reaktionspartner war ein öl-löslichen Phosphoester (Phenyldi(undec-10-en-1-yl)phosphat). Anhand von NMR-Spektren wurde gezeigt, dass die Kapselbildung auf Olefin Kreuzmetathese beruht. Im Vergleich zu konventionellen Estern haben Phosphorester eine weitere Möglichkeit zur chemischen Funktionalisierung. Dies wurde exemplarisch durch die Verwendung von fluoreszenzmarkierten Phosphoestern gezeigt. Die Markierung wurde verwendet, um die pH-induzierte Abbaubarkeit der Nanokapseln mittels Fluoreszenz-Korrelations-Spektroskopie zu beobachten. Ziel des zweiten Projekts war es, Nanostrukturen zu entwickeln, um Infektionen mit Antibiotika-resistenten Bakterien lokal zu behandeln. Dazu wurden mit Dextranmethacrylat vernetzte Poly(acrylamid) basierte Nanogele synthetisiert und Zinknitrat zugesetzt. Die Synthese der Nanogele wurde erweitert, um durch Vernetzung freier Alkoholgruppen mit Toluoldiisocyanat eine Kapselschale zu erhalten. Die Schalenbildung spiegelte sich in einer geringeren Quellbarkeit der Gel- Schale-Hybride wieder. Die erhaltenen Gel-Schale-Hybride waren in der Lage das Wachstum von zwei Methicillin-resistenten Bakterienstämmen (S. aureus) zu unterdrücken und verzögern. Die synthetisierten Hybridstrukturen könnten in der Beschichtung von Wundauflagen Verwendung finden, um bakterielle Infektionen lokal und direkt nach Ausbruch zu behandeln. Ziel des dritten Projektes war es, die wichtigen Parameter in der Herstellung von Nanokapseln mit hoher Kontrastmittel Sensitivität zu identifizieren. Relaxivität/Signalsensitivität des Kontrastmittels ist von großer Bedeutung für die Bildgebung mittels MRI, dies kann durch die Begrenzung der Mobilität des Kontrastmittels erreicht werden. Aufgrund seiner hohen Komplexstabilität und seiner klinischen Bedeutung wurde das Kontrastmittel Gadobutrol für die Verkapselung verwendet. Das Kontrastmittel wurde in Polyharnstoff-Kapseln eingeschlossen, die durch einen inversen Miniemulsion-Prozess hergestellt wurden. Um die Viskosität im Inneren der Nanokapsel zu erhöhen, wurden zusätzlich Saccharose, Dextran und Polyacrylsäure verkapselt. In Gegenwart von Saccharose konnte die Relaxivität verdoppelt werden. Dies gründet sich vermutlich auf einem Second-sphere Effekt der Saccharose, einer auf Wasserstoffbrückenbindungen beruhende Interaktion von Kontrastmittel und Saccharose.

Evolution of multidrug-resistant Staphylococcus aureus infections in horses and colonized personnel in an equine clinic between 2005 and 2010

A total of 70 Staphylococcus aureus isolates from postoperative infections in hospitalized horses were isolated between January 2005 and January 2011. Among them, 12 isolates were methicillin-susceptible S. aureus (MSSA), 18 were borderline-oxacillin-resistant S. aureus (BORSA), and 40 were methicillin-resistant S. aureus (MRSA). During the same period, the equine clinic personnel were screened for nasal carriage of BORSA and MRSA. Genotyping revealed that BORSA ST1(MLST)-t2863(spa) isolates were responsible for most equine infections and were the main isolates found in colonized members of the personnel between 2005 and 2007, and that in 2007, MRSA ST398-t011-IVa(SCCmec) emerged in infection sites and personnel, replacing BORSA. Besides decreased susceptibility to oxacillin, all MRSA and BORSA of these two major clonal lineages displayed resistance to gentamicin and kanamycin conferred by the aac(6')-Ie-aph(2')-Ia gene and to trimethoprim conferred by dfr(K) in MRSA and dfr(A) in BORSA. All MRSA had additional resistance to tetracycline conferred by tet(M), whereas BORSA generally also display resistance to streptomycin conferred by str. The number of hospital-acquired MRSA infections in horses could be limited after the introduction of basic hygiene measures and personnel decolonization. Two MRSA carriers could not be decolonized using mupirocin, and a year after decolonization, additional members were recolonized with MRSA. Hygiene measures should, therefore, be maintained to limit the transmission of S. aureus between personnel and horses.

Bacterial infections in horses: a retrospective study at the University Equine Clinic of Bern

Bacterial infections present a major challenge in equine medicine. Therapy should be based on bacteriological diagnosis to successfully minimize the increasing number of infections caused by multidrug-resistant bacteria. The present study is a retrospective analysis of bacteriological results from purulent infections in horses admitted at the University Equine Clinic of Bern from 2004 to 2008. From 378 samples analyzed, 557 isolates were identified, of which Staphylococcus aureus, Streptococcus equi subsp. zooepidemicus and coliforms were the most common. Special attention was paid to infections with methicillin-resistant S. aureus (MRSA) ST398 and a non-MRSA, multidrug-resistant S. aureus clone ST1 (BERN100). Screening of newly-admitted horses showed that 2.2 % were carriers of MRSA. Consequent hygiene measures taken at the Clinic helped to overcome a MRSA outbreak and decrease the number of MRSA infections.

Antimicrobial treatment concepts for orthopaedic device-related infection

Successful management of orthopaedic device-related infections requires combined surgical and antimicrobial therapy. Because of the heterogeneity of clinical situations, controlled trials are lacking. Although rational concepts for surgical treatment have been published, many aspects of antimicrobial therapy are still not well documented. In this review, some of these knowledge gaps are discussed, and rational arguments for initial parenteral treatment are presented. In addition, the interpretation of data regarding bone penetration is discussed. Whereas rifampin is now a standard combination partner in the treatment of staphylococcal infections, its role against other microorganisms is still unclear. Finally, in view of the increasing prevalence of methicillin-resistant staphylococci and their decreasing susceptibility to vancomycin, data are provided on linezolid and daptomycin, which can potentially be used in bone and joint infections.

Presence of new mecA and mph(C) variants conferring antibiotic resistance in Staphylococcus spp. isolated from the skin of horses before and after clinic admission

Because of the frequency of multiple antibiotic resistance, Staphylococcus species often represent a challenge in incisional infections of horses undergoing colic surgery. To investigate the evolution of antibiotic resistance patterns before and after preventative peri- and postoperative penicillin treatment, staphylococci were isolated from skin and wound samples at different times during hospitalization. Most staphylococci were normal skin commensals and belonged to the common coagulase-negative group. In some cases they turned out to be opportunistic pathogens present in wound infections. MICs were determined for 12 antibiotics, and antibiotic resistance genes were detected by microarray. At hospital admission, horses harbored staphylococci that were susceptible to antibiotics or resistant to one group of drugs, mainly due to the presence of new variants of the methicillin and macrolide resistance genes mecA and mph(C), respectively. After 3 days, the percentage of Staphylococcus isolates displaying antibiotic resistance, as well as the number of resistance genes per isolate, increased moderately in hospitalized horses without surgery or penicillin treatment but dramatically in hospitalized horses after colic surgery as well as penicillin treatment. Staphylococcus species displaying multiple resistance were found to harbor mainly genes conferring resistance to beta-lactams (mecA and blaZ), aminoglycosides [str and aac(6')-Ie-aph(2')-Ia], and trimethoprim [dfr(A) and dfr(D)]. Additional genes conferring resistance to macrolides [mph(C), erm(C), and erm(B)], tetracycline [tet(K) and tet(M)], chloramphenicol [cat(pC221) and cat(pC223)], and streptothricin (sat4) appeared in several strains. Hospitalization and preventive penicillin use were shown to act as selection agents for multidrug-resistant commensal staphylococcal flora.