Untersuchungen zur Biofilmbildung bei dem klinischen Isolat Enterococcus faecalis 1.10

In der vorliegenden Arbeit wurde die Biofilmbildung bei einem klinischen Isolat von Enterococcus faecalis untersucht. Der Prozess der Biofilmbildung ist in mehrere Abschnitte unterteilt und beinhaltet zu Beginn eine Anhaftung von Zellen an Oberflächen. Dieser adhäsive Schritt wird unter anderem durch Pili vermittelt. Pili bei Grampositiven Mikroorganismen sind kovalent mit der Zellwand verknüpfte Proteinstrukturen, die eine Anheftung an biotische und abiotische Oberflächen sowie den Zell-Zell-Kontakt vermitteln. Bei den Analysen dieser Doktorarbeit lag ein besonderes Interesse bei eben diesen Pili, die für Enterococcus faecalis die Namen Ebp (endocarditis and biofilm associated pili) und Bee (biofilm enhancer in enterococci) tragen. Codiert werden sie durch die entsprechenden ebp-/bee-Loci, deren Aufbau unter den Grampositiven Mikroorganismen hochkonserviert ist. Die Loci bestehen aus Pilusuntereinheiten-codierenden Genen und colokalisierten Pilus-spezifischen Sortase Genen. Während in der Regel drei verschiedene Pilusuntereinheiten vorliegen, kann die Anzahl der Sortasen zwischen einer und zwei variieren. Bei den Experimenten wurde neben einer Komplementationsstudie zu einer Bee-Pilus Defekt-Mutante (1.10.16) das Hauptaugenmerk auf die Analyse des zweiten Pilus (Ebp) gelegt, um die Pilisituation bei Isolat 1.10 im Detail darzustellen Zusätzlich sollten weitere Oberflächenassoziierte Proteinstrukturen bei Isolat 1.10 detektiert werden, die gegebenenfalls an der Biofilmbildung beteiligt sind. Weitere Versuche zur Charakterisierung des Bee-Pilus wurden im Laufe dieser Arbeit durchgeführt, blieben jedoch bisher erfolglos. Die Biofilm-/Pilus-Defekt-Mutante 1.10.16 zeigte aufgrund einer Punktmutation (Pm) in der Pilus-spezifischen Sortase 1 des bee-Locus eine geschwächte Fähigkeit zur Anheftung an abiotische Oberflächen, sowie das Fehlen der Bee2 Untereinheit im Pilus. Nach Komplementation der Mutante (1.10.16K) mit dem Wildtyp-srt1 Gen, wurde die starke Biofilmbildungsfähigkeit zurück erlangt. Die Experimente zeigten, dass der Pilus-Defekt auf die Pm im srt1 Gen zurückzuführen war und der Bee-Pilus in Stamm 1.10.16K wieder korrekt gebildet wurde. Zu sehen war dies in Rasterelektronenmikroskopischen Aufnahmen und ebenfalls im massenspektrometrischen Nachweis aller 3 Pilusuntereinheiten im Bee-Pilus charakteristischen High-Molecular-Weight Komplex (~ 250 kDa). Durch Sequenzierungen konnte gezeigt werden, dass zwei Gene des ebp-Locus (ebpR und ebpC) bei Isolat 1.10 durch die Insertion von IS-Elementen IS1062 und IS6770 inaktiviert wurden. Der proteinbiochemische Nachweis über Pilusspezifische Antikörper gegen die Untereinheiten des Ebp-Pilus verlief negativ. Zusätzlich konnte gezeigt werden, dass die mRNA der beiden inaktivierten Gene nicht gebildet wurde. Dies führte folglich zum vollständigen Verlust des Ebp-Pilus bei Isolat 1.10. Zusammen mit den Ergebnissen der Komplementation konnte somit der große Einfluss mindestens eines intakten Pilus auf die Biofilmbildung gezeigt werden. Sind beide Pili durch Insertionen bzw. Mutationen inaktiviert, kommt es zu einer deutlichen Abnahme der Biofilmbildungsstärke. Dass trotzdem noch ein Biofilm gebildet wurde, zeigt den multifaktoriellen Zusammenhang bzw. Einfluss im Biofilmbildungsprozess. Über das gezielte Markieren von Oberflächenproteinen intakter Zellen mittels der Oberflächenbiotinylierung, konnten in der SDS-PAGE Unterschiede im Bandenmuster im Vergleich zur unbehandelten Probe erkannt werden. Die massenspektrometrische Identifikation dieser Proteine erfolgte bisher nicht, jedoch sind diese vorläufigen Ergebnisse vielversprechender Natur für die Identifikation und Aufklärung der Oberflächenproteinsituation bei Isolat 1.10.

Evaluación muticéntrica de la actividad antimicrobiana in vitro de tigeciclina en aislados obtenidos de pacientes hospitalizados en Colombia

El aumento en la resistencia bacteriana es un problema global que afecta también a nuestro país y que puede llevar a fracasos terapéuticos, peores desenlaces clínicos, uso de terapia combinada, mayor riesgo de interacciones medicamentosas y de reacciones adversas asi como a aumento de los costos del tratamiento. Tigeciclina, un nuevo antibiótico de la clase de las glicilciclinas ha mostrado una promisoria actividad antibacteriana in vitro contra bacterias comunes incluyendo multiresistentes que cada vez son más prevalentes en nuestro país especialmente a nivel hospitalario. Este estudio fue desarrollado para determinar la actividad de tigeciclina en nuestro medio y conocer su potencial utilidad.

Perfil microbiológico, prevalencia de resistencia antibiótica y patrones de susceptibilidad en infección urinaria en una población pediátrica

Introducción: El incremento de la resistencia antibiótica se considera un problema de salud pública con consecuencias clínicas y económicas, por lo tanto se determinará la prevalencia de resistencia antibiótica en Infección del Tracto Urinario (ITU, el perfil microbiológico y los patrones de susceptibilidad en una población pediátrica atendida en la Fundación Cardioinfantil. Materiales y métodos: Estudio observacional de corte transversal, retrospectivo, entre 1 mes a 18 años de edad, con diagnóstico de ITU comunitaria atendidos entre Enero de 2011 y Diciembre de 2013. Se excluyeron pacientes con dispositivos en la vía urinaria, instrumentación quirúrgica previa, trayectos fistulosos entre la vía urinaria y sistema digestivo, ITU luego de 48 horas de hospitalización y recaída clínica en tratamiento. Se estableció la prevalencia de ITU resistente y se realizó un análisis descriptivo de la información. Resultados: Se evaluaron 385 registros clínicos, con una mediana de 1.08 años (RIQ 0.8 – 4.08), el 73.5% eran niñas. La fiebre predominó (76.5%), seguido de emesis (32.0%), disuria (23.7%) y dolor abdominal (23.1%). El uropatógeno más frecuente fue E.coli (75%), seguido de Proteus mirabilis (8.5%) y Klebsiella spp. (8.3%). La Ampicilina, el Trimetropim sulfametoxazol, la Ampicilina sulbactam y el ácido nalidixico tuvieron mayor tasa de resistencia. La prevalencia de BLEE fue 5.2% y AmpC 3.9%. La prevalencia de resistencia antimicrobiana fue de 11.9%. Conclusiones: La E.coli es el uropatogeno más frecuentemente aislado en ITU, con resistencia a la ampicilina en 60.2%, cefalosporinas de primera generación en 15.5%, trimetropin sulfametoxazol en 43.9%, cefepime 4.8%. La prevalencia de resistencia antimicrobiana fue de 11.9%.

Perfil de resistencia microbiológico en ciudados intensivos adultos en la fundación Santa Fe de Bogotá año 2014

Se realizó un estudio descriptivo, retrospectivo; se usó la base de datos de los aislamientos microbiológicos documentados en las UCI de la Fundación Santa fe de Bogotá para el año 2014. La prevalencia de bacterias resistentes en los aislamientos de la FSFB no es baja, por lo que se requiere una terapia empírica acertada acorde con la flora local. Se requieren estudios analíticos para evaluar factores asociados al desarrollo de gérmenes multi resistentes y mortalidad por sepsis

Estudio de las comunidades microbianas de embutidos fermentados ligeramente acidificados mediante técnicas moleculares. Estandarización, seguridad y mejora tecnológica.

Los embutidos fermentados ligeramente acidificados son un grupo de productos tradicionales mediterráneos, caracterizados por un pH superior a 5,3. Para un control eficiente de la seguridad microbiológica de los embutidos se necesitan técnicas rápidas para la identificación y recuento de los microorganismos patógenos a estudiar. En el presente trabajo, se desarrolló una técnica para la enumeración de L. monocytogenes que combinó el método del número más probable y la identificación mediante PCR específica. Para la detección de Salmonella spp. y L. monocytogenes se desarrolló un sistema de PCR-multiplex que permitió la identificación de ambos patógenos de forma simultánea en una sola reacción. El estudio de la calidad microbiológica de los embutidos fermentados ligeramente acidificados se completó con la caracterización de las comunidades microbianas más importantes en estos productos. Se identificaron a nivel de especie los aislados de bacterias del ácido láctico (BAL), de enterococos y de cocos gram-positivos catalasa-positivos (CGC+). Posteriormente se realizó una tipificación molecular de los mismos mediante RAPD y análisis del perfil plasmídico y se estudiaron las principales características de interés higiénico-sanitario y tecnológico de las cepas. Mediante PCR se identificó Lactobacillus sakei como la especie predominante (74%), seguida por Lactobacillus curvatus (21,2%). La actividad aminoácido-descarboxilasa se asoció a la especie L. curvatus (el 66% de los aislados presentaron esta actividad). La identificación de los enterococos se realizó mediante PCR-multiplex y por secuenciación del gen sodA. Enterococcus faecium fue la especie de enterococos predominante (51,9%) seguida por Enterococcus faecalis (14,2%). Todas las cepas de E. faecalis presentaron genes asociados a factores de virulencia. E. faecalis presentó mayor resistencia a antibióticos que el resto de las especies de enterococos estudiadas. Tan sólo una cepa de E. faecium presentó el genotipo vanA (que confiere resistencia de alto nivel a la vancomicina). La identificación de los aislados de CGC+ (mediante PCR específica y amplificación de la región intergénica 16S-23S ARNr) demostró que Staphylococcus xylosus es la especie predominante en los embutidos fermentados ligeramente acidificados (80,8%). La amina biógena más común en los CGC+ fue la feniletilamina, producida por un 10,8% de aislados. Un pequeño porcentaje de aislados fueron mecA+ (4,6%), presentando además resistencia a múltiples antibióticos. El potencial enterotoxigénico de las cepas de CGC+ fue muy reducido (3,3% de los aislados), detectándose únicamente el gen entC. El estudio pormenorizado de las comunidades bacterianas de interés permitió la selección de 2 cepas de L. sakei y 2 cepas de S. xylosus con características tecnológicas e higiénico-sanitarias óptimas. Para evaluar su efectividad como cultivos iniciadores se elaboraron dos tipos de embutidos ligeramente ácidos, chorizo y fuet, inoculados con microorganismos patógenos (Salmonella spp., L. monocytogenes y S. aureus). El uso de cultivos iniciadores permitió el control de L. monocytogenes, Enterobacteriaceae y Enterococcus así como del contenido en aminas biógenas. Los recuentos de Salmonella spp. disminuyeron de forma significante durante la maduración de los embutidos, independientemente del uso de cultivos iniciadores. El uso del tratamiento de alta presión (400 MPa) en los embutidos madurados consiguió la ausencia de Salmonella spp. en los lotes tratados.

The effects of probiotics on the composition of the intestinal microbiota following antibiotic therapy

The effects of probiotic supplementation on the intestinal re-growth microbiota following antibiotic therapy were studied in a double-blind placebo-controlled study. In the placebo group, numbers of facultative anaerobes and enterobacteria increased significantly, and at day 35 the numbers were significantly higher in the placebo group than in the active group; in the active group, the numbers of bacteroides increased significantly. Although the numbers of enterococci in both groups did not change, in the placebo group the number of patients harbouring antibiotic-resistant enterococci post therapy increased significantly. There was no change in the incidence rate of antibiotic resistance among the patients in the probiotic group.

Description of Enterococcus canis sp nov from dogs and reclassification of Enterococcus porcinus Teixeira et al. 2001 as a junior synonym of Enterococcus villorum Vancanneyt et al. 2001

Strains from anal swabs and chronic otitis externa in dogs were shown to be phylogenetically related to the Enterococcus faecium species group. They shared a number of phenotypic characteristics with these species, but they could be easily differentiated by biochemical reactions. In addition, the canine strains were unusual in their nearly complete failure to grow on sodium azide-containing enterococci-selective media and in their Voges-Proskauer reactions (usually negative). By using 16S rRNA sequencing and DNA-DNA hybridization of representative strains, as well as tDNA interspacer gene PCR and SDS-PAGE of whole-cell proteins, the group of canine strains was shown to constitute a novel enterococcal species. The name Enterococcus canis sp. nov. is proposed for this species, with LMG 12316(T) (= CCUG 46666(T)) as the type strain. Concurrently, the taxonomic situation and nomenclatural position of Enterococcus porcinus were investigated. As no phenotypic or genotypic differences were found between this species and Enterococcus villorum, the name E. porcinus is considered to be a junior synonym of E. villorum.

A double-blind, placebo-controlled, crossover-designed probiotic feeding study in children diagnosed with autistic spectrum disorders

There is growing interest in the role of gastrointestinal (GI) pathology and clinical expression of autism. Recent studies have demonstrated differences in the faecal clostridial populations harboured by autistic and non-autistic children. The potential of Lactobacillus plantarum WCSF1 (a probiotic) to modulate the gut microbiota of autistic subjects was investigated during a double-blind, placebo-controlled, crossover-designed feeding study. The faecal microbiota, gut function and behaviour scores of subjects were examined throughout the 12-week study. Lactobacillus plantarum WCFS1 feeding significantly increased Lab158 counts (lactobacilli and enterococci group) and significantly reduced Erec482 counts (Clostridium cluster XIVa) compared to placebo. Probiotic feeding also resulted in significant differences in the stool consistency compared to placebo and behaviour scores (total score and scores for some subscales) compared to baseline. The major finding of this work was the importance of study protocol in relation to the specific considerations of this subject population, with an extremely high dropout rate seen (predominantly during the baseline period). Furthermore, the relatively high inter-individual variability observed suggests that subsequent studies should use defined subgroups of autistic spectrum disorders, such as regressive or late-onset autism. In summary, the current study has highlighted the potential benefit of L. plantarum WCFS1 probiotic feeding in autistic individuals.

Predicting microbial pollution concentrations in UK rivers in response to land use change

The Water Framework Directive has caused a paradigm shift towards the integrated management of recreational water quality through the development of drainage basin-wide programmes of measures. This has increased the need for a cost-effective diagnostic tool capable of accurately predicting riverine faecal indicator organism (FIO) concentrations. This paper outlines the application of models developed to fulfil this need, which represent the first transferrable generic FIO models to be developed for the UK to incorporate direct measures of key FIO sources (namely human and livestock population data) as predictor variables. We apply a recently developed transfer methodology, which enables the quantification of geometric mean presumptive faecal coliforms and presumptive intestinal enterococci concentrations for base- and high-flow during the summer bathing season in unmonitored UK watercourses, to predict FIO concentrations in the Humber river basin district. Because the FIO models incorporate explanatory variables which allow the effects of policy measures which influence livestock stocking rates to be assessed, we carry out empirical analysis of the differential effects of seven land use management and policy instruments (fiscal constraint, production constraint, cost intervention, area intervention, demand-side constraint, input constraint, and micro-level land use management) all of which can be used to reduce riverine FIO concentrations. This research provides insights into FIO source apportionment, explores a selection of pollution remediation strategies and the spatial differentiation of land use policies which could be implemented to deliver river quality improvements. All of the policy tools we model reduce FIO concentrations in rivers but our research suggests that the installation of streamside fencing in intensive milk producing areas may be the single most effective land management strategy to reduce riverine microbial pollution.

The inhibitory effect of natural microflora of food on growth of Listeria monocytogenes in enrichment broths

The aims of this study were to (i) compare the inhibitory effects of the natural microflora of different foods on the growth of Listeria monocytogenes during enrichment in selective and non-selective broths; (ii) to isolate and identify components of the microflora of the most inhibitory food; and (iii) to determine which of these components was most inhibitory to growth of L. monocytogenes in co-culture studies. Growth of an antibioticresistant marker strain of L. monocytogenes was examined during enrichment of a range of different foods in Tryptone Soya Broth (TSB), Half Fraser Broth (HFB) and Oxoid Novel Enrichment (ONE) Broth. Inhibition of L. monocytogenes was greatest in the presence of minced beef, salami and soft cheese and least with prepared fresh salad and chicken pâté. For any particular food the numbers of L. monocytogenes present after 24 h enrichment in different broths increased in the order: TSB, HFB and ONE Broth. Numbers of L. monocytogenes recovered after enrichment in TSB were inversely related to the initial aerobic plate count (APC) in the food but with only a moderate coefficient of determination (R2) of 0.51 implying that microbial numbers and the composition of the microflora both influenced the degree of inhibition of L. monocytogenes. In HFB and ONE Broth the relationship between APC and final L. monocytogenes counts was weaker. The microflora of TSB after 24 h enrichment of minced beef consisted of lactic acid bacteria, Brochothrix thermosphacta, Pseudomonas spp., Enterobacteriaceae, and enterococci. In co-culture studies of L. monocytogenes with different components of the microflora in TSB, the lactic acid bacteria were the most inhibitory followed by the Enterobacteriaceae. The least inhibitory organisms were Pseudomonas sp., enterococci and B. thermosphacta. In HFB and ONE Broth the growth of Gram-negative organisms was inhibited but lactic acid bacteria still reached high numbers after 24 h. A more detailed study of the growth of low numbers of L. monocytogenes during enrichment of minced beef in TSB revealed that growth of L. monocytogenes ceased at a cell concentration of about 102 cfu/ml when lactic acid bacteria entered stationary phase. However in ONE Broth growth of lactic acid bacteria was slower than in TSB with a longer lag time allowing L. monocytogenes to achieve much higher numbers before lactic acid bacteria reached stationary phase. This work has identified the relative inhibitory effects of different components of a natural food microflora and shown that the ability of low numbers of L. monocytogenes to achieve high cell concentrations is highly dependent on the extent to which enrichment media are able to inhibit or delay growth of the more effective competitors.

In vitro fermentation and prebiotic potential of novel low molecular weight polysaccharides derived from agar and alginate seaweeds

Fermentation properties and prebiotic potential of novel low molecular weight polysaccharides (LMWPs) derived from agar and alginate bearing seaweeds was investigated. Ten LMWPs were supplemented to pH, temperature controlled anaerobic batch cultures inoculated with human feces from three donors, in triplicate. Microbiota changes were monitored using Fluorescent in-situ hybridization and short chain fatty acids, the fermentation end products were analysed using gas chromatography. Of the ten LMWPs tested, Gelidium seaweed CC2253 of molecular weight 64.64 KDa showed a significant increase in bifidobacterial populations from log(10) 8.06 at 0 h to log(10) 8.55 at 24 h (p = 0.018). For total bacterial populations, alginate powder CC2238 produced a significant increase from log(10) 9.01 at 0 h to log(10) 9.58 at 24 h (p = 0.032). No changes were observed in the other bacterial groups tested viz. Bacteroides, Lactobacilli/Enterococci, Eubacterium rectale/Clostridium coccoides and Clostridium histolyticum. The polysaccharides also showed significant increases in total SCFA production, particularly acetic and propionic acids, indicating that they were readily fermented. In conclusion, some LMWPs derived from agar and alginate bearing seaweeds were fermented by gut bacteria and exhibited potential to be used a novel source of prebiotics.

Effect of the growth promoter avilamycin on emergence and persistence of antimicrobial resistance in enteric bacteria in the pig

Aim: To assess the effect of the growth promoter avilamycin on emergence and persistence of resistance in enteric bacteria in the pig. Methods and Results: Pigs ( treated with avilamycin for 3 months and controls) were challenged with multiresistant Salmonella Typhimurium DT104 and faecal counts were performed for enterococci, Escherichia coli, S. Typhimurium and Campylobacter ( before, during and 5 weeks post-treatment). Representative isolates were tested for antibiotic resistance and for the presence of resistance genes. Avilamycin-resistant Enterococci faecalis (speciated by PCR) were isolated from the treated pigs and continued to be detected for the first week after treatment had ceased. The avilamycin- resistance gene was characterized by PCR as the emtA gene and speciation by PCR. MIC profiling confirmed that more than one strain of Ent. faecalis carried this gene. There was no evidence of increased antimicrobial resistance in the E. coli, Salmonella and Campylobacter populations, although there was a higher incidence of tetB positive E. coli in the treated pigs than the controls. Conclusion: Although avilamycin selects for resistance in the native enterococci population of the pig, no resistant isolates were detected beyond 1 week post-treatment. This suggests that resistant isolates were unable to persist once selective pressure was removed and were out-competed by the sensitive microflora. Significance and Impact of the Study: Our data suggest the risk of resistant isolates becoming carcass contaminants and infecting humans could be minimized by introducing a withdrawal period after using avilamycin and prior to slaughter.

The Challenges of Antimicrobial Resistance in Brazil

Brazil is a country with continental proportions with high geographic and economic diversity. Despite its medical centers of excellence, antimicrobial resistance poses a major therapeutic challenge. Rates of methicillin-resistant Staphylococcus aureus are up to 60% and are related to an endemic Brazilian clone. Local resistance to vancomycin in Enterococci was first related to Enterococcus faecalis, which differs from European and American epidemiology. Also, local Klebsiella pneumoniae and Escherichia coli isolates producing extended-spectrum beta-lactamases have a much higher prevalence (40%-50% and 10%-18%, respectively). Carbapenem resistance among the enterobacteriaceae group is becoming a major problem, and K. pneumoniae carbapenemase isolates have been reported in different states. Among nonfermenters, carbapenem resistance is strongly related to SPM-1 (Pseudomonasaeruginosa) and OXA-23 (Acinetobacter baumannii complex) enzymes, and a colistin-only susceptible phenotype has also emerged in these isolates, which is worrisome. Local actions without loosing the global resistance perspective will demand multidisciplinary actions, new policies, and political engagement.

Faecal bacteria in Perna perna (Linnaeus, 1758) (Mollusca: Bivalvia) for biomonitoring coastal waters and seafood quality

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

Potential microbiological contamination of effluents in poultry and swine abattoirs

Health risks in the effluents of seven swine abattoirs and of seven poultry abattoirs were evaluated with regard to environment degradation and to dissemination of pathogenic microorganisms during the rainy and dry seasons. Supply-water samples from affluents and effluents of the treatment systems at different sites within the abattoir processing system were analysed. Similarly, water samples from the three recipient sites (emission point, 100 m upstream, 100 m downstream) were also analysed. Temperature, free residual chlorine (FRC), total coliform bacteria, Escherichia coli, enterococci, identification and serotyping of salmonellae were assessed. Scalding is the most significant stage in the slaughtering chain (P<0.05) when temperature is taken into account. Temperatures Lit effluents and at the sampled sites in the water bodies accorded to state and federal legislation standards. Supply waters did not meet the standards for FRC and microbial count standards according to the Ministry of Health and within limits imposed by the Industrial and Sanitary Inspection Regulations for Animal Products. Feather plucking and evisceration in Poultry slaughter and the cleansing of carcasses and facilities in Poultry and swine slaughtering had the highest contamination impact. The three loci at the water bodies were above the microbiological standards for classes II and III sites, in conformity with Law 8468 of the state of São Paulo, Brazil and Conama. Salmonella was found at several sites during slaughter, at both types of abattoirs, including in the effluent treatment system. This showed that these sites were the dissemination sources of the microorganism.