Aerobic bacterial profile and antibiotic resistance in patients with diabetic foot infections

ABSTRACTINTRODUCTION: This study aimed to determine the frequencies of bacterial isolates cultured from diabetic foot infections and assess their resistance and susceptibility to commonly used antibiotics.METHODS: This prospective study included 41 patients with diabetic foot lesions. Bacteria were isolated from foot lesions, and their antibiotic susceptibility pattern was determined using the Kirby-Bauer disk diffusion method and/or broth method [minimum inhibitory concentration (MIC)].RESULTS: The most common location of ulceration was the toe (54%), followed by the plantar surface (27%) and dorsal portion (19%). A total of 89 bacterial isolates were obtained from 30 patients. The infections were predominantly due to Gram-positive bacteria and polymicrobial bacteremia. The most commonly isolated Gram-positive bacteria were Staphylococcus aureus, followed by Staphylococcus saprophyticus, Staphylococcus epidermidis, Streptococcus agalactiae, and Streptococcus pneumoniae. The most commonly isolated Gram-negative bacteria were Proteus spp. and Enterobacterspp., followed by Escherichia coli, Pseudomonasspp., and Citrobacterspp. Nine cases of methicillin-resistant Staphylococcus aureus (MRSA) had cefoxitin resistance, and among these MRSA isolates, 3 were resistant to vancomycin with the MIC technique. The antibiotic imipenem was the most effective against both Gram-positive and Gram-negative bacteria, and gentamicin was effective against Gram-negative bacteria.CONCLUSIONS: The present study confirmed the high prevalence of multidrug-resistant pathogens in diabetic foot ulcers. It is necessary to evaluate the different microorganisms infecting the wound and to know the antibiotic susceptibility patterns of the isolates from the infected wound. This knowledge is crucial for planning treatment with the appropriate antibiotics, reducing resistance patterns, and minimizing healthcare costs.

How well do individuals predict the selling prices of their homes?

Self-reported home values are widely used as a measure of housing wealth by researchers employing a variety of data sets and studying a number of different individual and household level decisions. The accuracy of this measure is an open empirical question, and requires some type of market assessment of the values reported. In this research, we study the predictive power of self-reported housing wealth when estimating sales prices utilizing the Health and Retirement Study. We find that homeowners, on average, overestimate the value of their properties by between 5% and 10%. More importantly, we are the first to document a strong correlation between accuracy and the economic conditions at the time of the purchase of the property (measured by the prevalent interest rate, the growth of household income, and the growth of median housing prices). While most individuals overestimate the value of their properties, those who bought during more difficult economic times tend to be more accurate, and in some cases even underestimate the value of their house. These results establish a surprisingly strong, likely permanent, and in many cases long-lived, effect of the initial conditions surrounding the purchases of properties, on how individuals value them. This cyclicality of the overestimation of house prices can provide some explanations for the difficulties currently faced by many homeowners, who were expecting large appreciations in home value to rescue them in case of increases in interest rates which could jeopardize their ability to live up to their financial commitments.

Evolution based on domain combinations: the case of glutaredoxins

Background: Protein domains represent the basic units in the evolution of proteins. Domain duplication and shuffling by recombination and fusion, followed by divergence are the most common mechanisms in this process. Such domain fusion and recombination events are predicted to occur only once for a given multidomain architecture. However, other scenarios may be relevant in the evolution of specific proteins, such as convergent evolution of multidomain architectures. With this in mind, we study glutaredoxin (GRX) domains, because these domains of approximately one hundred amino acids are widespread in archaea, bacteria and eukaryotes and participate in fusion proteins. GRXs are responsible for the reduction of protein disulfides or glutathione-protein mixed disulfides and are involved in cellular redox regulation, although their specific roles and targets are often unclear. Results: In this work we analyze the distribution and evolution of GRX proteins in archaea,bacteria and eukaryotes. We study over one thousand GRX proteins, each containing at least one GRX domain, from hundreds of different organisms and trace the origin and evolution of the GRX domain within the tree of life. Conclusion: Our results suggest that single domain GRX proteins of the CGFS and CPYC classes have, each, evolved through duplication and divergence from one initial gene that was present in the last common ancestor of all organisms. Remarkably, we identify a case of convergent evolution in domain architecture that involves the GRX domain. Two independent recombination events of a TRX domain to a GRX domain are likely to have occurred, which is an exception to the dominant mechanism of domain architecture evolution.

Lujan teräksen hyödyntäminen taittopuomissa

Työn päätavoitteena on ennakkoluulottomasti etsiä uudenlaista ratkaisua Mantsinen -lastausnosturin taittopuomiin ja pyrkiä löytämään kevyempi tarkoitukseen sopiva rakenne hyödyntämällä lujia teräksiä. Työ painottuu eri ratkaisuvaihtoehtojen kartoittamiseen ja niiden arviointiin elementtimenetelmää hyödyntäen. Arvioinnissa painotettiin tarkoituksen mukaisuutta ja väsymiskestävyyttä. Tutkimus suoritetaan vertailemalla vanhaa ja uutta ratkaisua keskenään. Työssä havaittiin, että ottamalla huomioon hitsattujen lujien terästen väsymisominaisuudet jo suunnittelussa, voidaan saada aikaan kevyempiä ja väsymisen kannalta kestävämpiä ratkaisuja.

Mobilisation of enterocyte fat stores by oral glucose in humans

Background and aims: When a high fat oral load is followed several hours later by further ingestion of nutrients, there is an early postprandial peak in plasma triacylglycerol (TG). The aim of this study was to investigate the location and release of lipid from within the gastrointestinal tract. Methods: Ten healthy patients undergoing oesopho-gastro-duodenoscopy (OGD) were recruited. At t=0, all patients consumed a 50 g fat emulsion and at t=5 hours they consumed either water or a 38 g glucose solution. OGD was performed at t=6 hours and jejunal biopsy samples were evaluated for fat storage. A subgroup of five subjects then underwent a parallel metabolic study in which postprandial lipid and hormone measurements were taken during an identical two meal protocol. Results: Following oral fat at t=0, samples from patients that had subsequently ingested glucose exhibited significantly less staining for lipid within the mucosa and submucosa of the jejunum than was evident in patients that had consumed only water (p=0.028). There was also less lipid storage within the cytoplasm of enterocytes (p=0.005) following oral glucose. During the metabolic study, oral glucose consumed five hours after oral fat resulted in a postprandial peak in plasma TG, chylomicron-TG, and apolipoprotein B48 concentration compared with oral water. Conclusion: After a fat load, fat is retained within the jejunal tissue and released into plasma following glucose ingestion, resulting in a peak in chylomicron-TG which has been implicated in the pathogenesis of atherosclerosis.

Fermentation of heated gluten systems by gut microflora

The Maillard reaction causes changes to protein structure and occurs in foods mainly during thermal treatment. Melanoidins, the final products of the Maillard reaction, may enter the gastrointestinal tract, which is populated by different species of bacteria. In this study, melanoidins were prepared from gluten and glucose. Their effect on the growth of faecal bacteria was determined in culture with genotype and phenotype probes to identify the different species involved. Analysis of peptic and tryptic digests showed that low molecular mass products are formed from the degradation of melanoidins. Results showed a change in the growth of bacteria. This in vitro study demonstrated that melanoidins, prepared from gluten and glucose, affect the growth of the gut microflora.

Caracterização molecular de estafilococos isolados de vacas com mastite subclínica e ordenhadores

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

Cicatrizes renais em crianças com refluxo vesicoureteral primário

OBJETIVO: verificar a incidência de cicatrizes renais em crianças com refluxo vesicoureteral primário, comparando com sexo, idade no diagnóstico, infecção febril, grau do refluxo e tipo de bactéria. MÉTODOS: estudo retrospectivo de 58 crianças, com idade entre dois meses a 11 anos, apresentando refluxo vesicoureteral primário, detectado pela uretrocistografia miccional, após episódio documentado de infecção urinária. Diagnóstico de cicatriz renal foi obtido pela cintilografia com DMSA cinco meses, no mínimo, após o tratamento da infecção urinária; em 40 crianças, o exame foi repetido após período de seis meses a seis anos. RESULTADOS: 45 crianças (77,6%) eram meninas e 13 (22,4%) eram meninos, 51,7% com idade menor ou igual a 2 anos. A incidência de cicatriz renal foi de 55,2%. Houve maior proporção significativa de cicatrizes renais no sexo feminino, na presença do sintoma febre e no refluxo dilatado (III, IV e V). Presença de febre e sexo feminino foram fatores de risco significativos na ocorrência de cicatriz renal (febre - OR= 6,19, e sexo feminino - OR= 4,12). Houve tendência da presença de cicatriz renal em maiores de 2 anos. O intervalo entre início dos sintomas e a primeira consulta foi maior nas crianças com cicatrizes renais. Novas cicatrizes renais foram observadas em 12,5%. CONCLUSÃO: a presença de febre e sexo feminino foram fatores de risco para presença de cicatrizes renais, principalmente no refluxo vesicoureteral dilatado. A alta incidência de cicatrizes renais neste estudo pode estar relacionada ao retardo do diagnóstico do refluxo vesicoureteral.

PCR Multiplex fluorescente para detecção de bactérias em sêmen bovino

Este estudo teve como objetivo avaliar o limiar de detecção da técnica de PCR multiplex fluorescente aliada a eletroforese capilar na detecção de agentes infecciosos em amostras de sêmen experimentalmente contaminadas com concentrações decrescentes das bactérias Brucella abortus, Leptospira interrogans sorovar pomona, Campylobacter fetus e Haemophilus somnus. Amostras de sêmen bovino foram experimentalmente contaminadas com concentrações decrescentes de bactérias obtidas através de diluições seriadas na base 10 de modo a obter-se amostras contendo desde 1 vez até 10-7 bactérias/mL a partir da concentração inicial de Leptospira pomona, Brucella abortus, Campylobacter fetus e Haemophilus somnus. As diluições foram efetuadas individualmente para cada bactéria, bem como nas diferentes concentrações necessárias para a padronização do teste de multiplex PCR. As extrações de DNA de todas as soluções contendo espermatozóides e bactérias analisadas no presente estudo foram realizadas segundo protocolo descrito por Heinemann et al. (2000). Os produtos de PCR multiplex foram avaliados por eletroforese em gel de poliacrilamida 8% e separação eletroforética por sistema capilar em equipamento automático de análise de fragmentos de DNA MegaBace. Observou-se a amplificação de fragmentos de 193pb, 330pb, 400pb e 415pb a partir do DNA de B. abortus, L. pomona, H. somnus, C. fetus, respectivamente. Na análise por eletroforese capilar de produtos da PCR multiplex do DNA para detecção simultânea dos quatro patógenos observou-se a sinal de positividade até a diluição de 10-3 bactérias/mL vezes da concentração inicial da solução estoque de cada bactéria. A técnica de PCR multiplex aliada à eletroforese capilar foi usada pela primeira vez para o diagnóstico direto de quatro bactérias patogênicas no sêmen, demonstrando ser um método rápido na detecção de bactérias causadoras de doenças reprodutivas.

Valor nutritivo do feno de Brachiaria decumbens Stapf cv. Basilisk submetido a tratamento com amônia anidra ou uréia

The effects of the ammoniation of Brachiaria decumbens hay was evaluated. The hay bales were distributed into a complete randomized block design, with four replications and they were submitted to the treatments: untreated or treated with anhydrous ammonia (NH3)(2,0 and 3,0% of the DM) or with urea (3,6 and 5,4% of the DM). All the hays bales remained under plastic cover for 45 days. After three days of aeration, samples were collected for the determination of the chemical composition, nitrogenous compounds fraction and the in vitro dry matter (IVDDM) and organic matter (IVDOM) digestibility. In the metabolic study, Saanen goats breed was used in a 5x5 Latin squares design, where the apparent digestibility, the voluntary intake and the nutritive value index were evaluated. The ammoniation increased the contents of the total N, N ammonia (N-NH3) and non-protein N, with high effect on the levels of 3,0% of NH3 and 5,4% of urea. There were no differences between the level of 3,0% of NH3 and 5,4% of urea for the total N, N-NH3 and NPN. However, the treatment with 3,0% of NH3 allowed a larger fixation of N in ADIN and NDIN forms. The ammoniation increased the IVDMD and IVDMO and reduced the contents of neutral detergent fiber (NDF), hemicellulose, acid detergent fiber (ADF) and lignin, but it did not alter the cellulose and gross energy contents. The ammoniation increased the DM, OM, CP, NDF, ADF, hemicellulose, cellulose and gross energy apparent digestibility and as well as the voluntary intake of DM, digestible DM, digestible OM, digestible protein, digestible energy and the nutritive value index. The ammoniation increased the hay nutritive value index, but there were no differences between the levels of NH3 and urea.

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.

Opportunistic microorganisms in individuals with lesions of denture stomatitis

The aim of this study was to isolate, quantify, identify, and compare opportunistic microorganisms (Candida and Staphylococcus genera and Enterobacteriaceae/Pseudomonadaceae families) from prosthesis-fitting surfaces, the hard palate, and mouth rinses of individuals wearing removable maxillary prosthesis with (50) and without (50) lesions of denture stomatitis (DS). The strains were collected and identified using phenotypic, biochemical and molecular tests. The counts of microorganisms were significantly higher in the group of individuals with DS (P < 0.05). C. albicans was the most frequently isolated yeast species in both groups, following by C. tropicalis and C. glabrata. Six isolates were identified as C. dubliniensis. S. aureus and S. epidermidis were the most frequent Staphylococcus species in both groups. Klebsiella pneumoniae was the predominant species in both groups. The association between Candida spp. and bacteria isolated in this study with DS suggests that these microorganisms may play important roles in the establishment and persistence of this disease. © 2013 Elsevier Inc.

Nefrocalcinose induzida pela hiperoxalúria: modelo experimental em ratos

Pós-graduação em Bases Gerais da Cirurgia - FMB

Estudo dos efeitos do nitrato de lítio na expansão de argamassas sujeitas a reação álcali-sílica

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Perfil de resistência aos antimicrobianos em coliformes isolados do Sistema Municipal de Abastecimento de Água de São José do Rio Preto-SP

Pós-graduação em Microbiologia - IBILCE