Infectious endocarditis caused by Nocardia sp.: histological morphology as a guide for the specific diagnosis

Nocardia is a rare opportunistic agent, which may affect immunocompromised individuals causing lung infections and exceptionally infective endocarditis (IE). There are few reports of IE caused by Nocardia sp., usually involving biological prostheses but rarely in natural valves. Its accurate microbiological identification may be hampered by the similarity with Rhodococcus equi and Corynebacterium spp. Here we report a case of native mitral valve IE caused by this agent in which the clinical absence of response to vancomycin and the suggestion of Nocardia sp. by histology pointed to the misdiagnosis of Corynebacterium spp. in blood cultures. The histological morphology can advise on the need for expansion of cultivation time and use of extra microbiological procedures that lead to the differential diagnosis with Corynebacterium spp. and other agents, which is essential to establish timely specific treatment, especially in immunocompromised patients.

An alternative method for purifying and detoxifying diphtheria toxin

Infections caused by Corynebacterium diphtheriae frequently induce situations in which very small doses of antigens injected intradermally can cause strong inflammatory reactions. This bacterium secretes the diphtheria toxin (DT), a virulence factor that can be lethal to the human organism at doses below 0.1 mu g/kg of body weight. The present work proposes alternative methods of DT purification using affinity chromatography and of DT detoxification through conjugating with the polymer methoxypolyethylene glycol activated (mPEG). Tests were performed to evaluate: the formation of edemas and the presence of dermonecrotic activity, in vitro cytotoxicity to Vero cells, the neutralizing activity of serum from guinea pigs immunized with the diphtheria toxoid inactivated with mPEG, and the immunogenic activity of the purified and modified toxin. The results indicated that purification with Blue Sepharose was an efficient method, yielding antigen purity equivalent to 2600 Lf/mg of protein nitrogen. The modification of the Purified Toxin with mPEG did not result in the formation of edema or necrosis although it was immunogenic and stimulated the formation of antibodies that could neutralize the Purified Toxin. The toxoid obtained from the purified toxin maintained its immunogenic characteristics, inducing antibodies with neutralizing activity; edema and necrosis were still observed, however. (C) 2011 Elsevier Ltd. All rights reserved.

Flora vaginal e correlação com aspectos citológicos

Com a finalidade de esclarecer a patogenicidade de microorganismos que compõem a microflora vaginal, particularmente nas chamadas vaginites inespecíficas e de determinar o valor da citologia como método para identificação da flora vaginal, foram estudadas 97 pacientes, realizando cultura, exame direto a fresco, Gram e citologia do material cérvico-vaginal. Entre os microorganismos de importância clínica reconhecida, Gardnerella vaginalis foi o mais freqüentemente isolado, 48,4%, seguido de Trichomonas vaginalis, 10,3%, Candida albicans, 7,2% e Neisseria gonorrhoeae, 1,1%. Alterações citológicas indicativas de cervicite e/ou vaginite estiveram presentes na maioria dos casos de G.vaginalis, C.albicans e em todos os casos de T.vaginalis. Foi ressaltada a importância da avaliação semi-quantitativa dos microorganismos nos meios de cultura. Na avaliação da citologia como método diagnóstico para a microflora vaginal, foi observada que este foi o melhor dos métodos utilizados na identificação de T.vaginalis, tendo sido detectado cerca de 50% dos casos de C.albicans. No diagnóstico de G.vaginalis a citologia foi positiva em 48,9% dos casos, destacando-se que dos 31 casos positivos ao exame citológico, oito tiveram culturas negativas para G.vaginalis, embora tenham sido isolados nestes últimos: Haemophilus sp. ou Corynebacterium sp.

Biofiltration of Air/Styrene and Air/Styrene/Acetone mixtures in a bubble column reactor

The goal of this work was the treatment of polluted waste gases in a bubble column reactor (BCR), in order to determinate the maximum value of reactor’s efficiency (RE), varying the inlet concentration (C in) of the pollutants. The gaseous mixtures studied were: (i) air with styrene and (ii) air with styrene and acetone. The liquid phase used to contain the biomass in the reactor was a basal salt medium (BSM), fundamental for the microorganisms’ development. The reactor used in this project consists of a glass column of 620mm height and inside diameter 75mm. In all essays there were continually measured: pH, dissolved oxygen and liquid’s temperature. Temperature and pH were controlled (T=24ºC, 7.0 ≤ pH ≤ 7.7). In all experiments the liquid volume (including the biomass) used in the reactor was kept constant (1.5L) as well as the total gas flowrate (1 L/min). Concerning the goal of the work, some parameters were calculated: the organic load (OL), removal efficiency (RE), elimination capacity (EC), biomass concentration (xf) and dry biomass concentration (Xdw). In a first series of experiments, the gas mixture used was air with styrene, varying its concentration from 191 mg.m-3 to 6500 mg.m-3.It was concluded that the RE maximum value (97%) was obtained for C in Sty = 4200 mg.m-3. For the maximum tested value of C in Sty, RE obtained was 20%. In a second step, the gaseous mixture included acetone, varying C in Sty between 225 mg.m-3 and 2659 mg.m-3 and C in Ac between 153mg.m-3 and 1389 mg.m-3. The aim of these tests was the determination of C in Ac for which RE was maximum, obtaining C in Ac = 750 mg.m-3. A third series of experiments was performed, in which C in Ac was maintained equal to that value and C in Sty was varied until higher values (5422 mg.m-3). RE maximum values obtained in this last series were 100% for styrene and 40% for acetone. One important conclusion is the fact that the microorganisms available degrade better styrene than acetone. On the ambit of this study, it was possible to identify the species available in biomass: Xanthobacter antotrophicus py2, Enterobacter aerogenes, Nocardia, Corynebacterium Spp., Rhodococcus rhodochrous e Pseudomonas Sp.

Efeito do glicerol e do telurito de potássio sôbre os grânulos metacromáticos e a morfologia do bacilo diftérico

Após ter-se salientado a importância da preservação da morfologia convencional do bacilo diftérico, para os propósitos do diagnóstico presuntivo de difteria, faz-se um estudo comparativo dos aspectos morfológicos de 10 amostras de Corynebacterium em quatro meios de uso mais comum para o isolamento dêsses germes, modificando êsses mesmos meios, em cada caso, pela inclusão de glicerol, de teluríto de potássio e de glicerol e telurito, em comparação com a fórmula original. Descreve-se uma técnica simples para a incorporação do telurito de potássio nos meios preparados por coagulação de proteínas animais (Loeffler e Pai). A apreciação da morfologia e da evidenciação de grânulos de volutina destacam o meio de Pai, com cêrca de 7 porcento de glicerol, entre 16 variações de meios de cultura estudadas, como o mais favorável para a demonstração da morfologia considerada típica no diagnóstico do bacilo diftérico.

Identification and purification of immunogenic proteins from nonliving promastigote polyvalent Leishmania vaccine (Leishvacin®)

Immunogenic proteins from nonliving promastigote polyvalent Leishmania vaccine against American tegumentary leishmaniasis (Leishvacin®), produced by Biobrás (Biochemistry of Brazil ), Montes Claros, State of Minas Gerais, Brazil, were identified and purified by polyacrylamide electrophoresis gel and electroelution. C57BL/10 mice were vaccinated with proteins with estimated molecular weights of 42, 46, 63, 66, 73, 87, 97, and 160kDa in three doses of 30µg of each protein at 15-day intervals combined with 250µg of Corynebacterium parvum followed by a challenge infection with 10(5) infective promastigotes from Leishmania (Leishmania) amazonensis. The ability of these proteins to induce immune response and protection was analyzed. No statistical difference was observed in the level of IFN-g induced by proteins in vaccinated groups in comparison with control groups. Six months after challenge infection, protection levels of 28.57; 42.86; 57.14; 42.86; 42.86, 57.14; 42.86 and 57.14% were demonstrated for each purified protein.

Protective immunity induced in mice by F8.1 and F8.2 antigens purified from Schistosoma mansoni eggs

Schistosoma mansoni soluble egg antigens (SEA) were fractionated by isoelectric focusing, resulting in 20 components, characterized by pH, absorbance and protein concentration. The higher absorbance fractions were submitted to electrophoresis, and fraction 8 (F8) presented a specific pattern of bands on its isoelectric point. Protein 3 was observed only on F8, and so, it was utilized to rabbit immunization, in order to evaluate its capacity of inducing protective immunity. IgG antibodies from rabbit anti-F8 serum were coupled to Sepharose, and used to obtain the specific antigen by affinity chromatography. This antigen, submitted to electrophoresis, presented two proteic bands (F8.1 and F8.2), which were transferred to nitrocellulose membrane (PVDF) and sequenciated. The homology of F8.2 to known proteins was determined using the Basic Local Alignment Search Tool program (BLASTp). Significant homologies were obtained for the rabbit cytosolic Ca2+ uptake inhibitor, and for the bird a1-proteinase inhibitor. Immunization of mice with F8.1 and F8.2, in the presence of Corynebacterium parvum and Al(OH)3 as adjuvant, induced a significant protection degree against challenge infection, as observed by the decrease on worm burden recovered from portal system.

Induction of protective immunity against Schistosoma mansoni infection by antigens purified from PIII, a fraction of adult worm, associated to the downregulation of granuloma formation

This study was performed in order to define Schistosoma mansoni antigens able to function as modulator agents in BALB/c mice granulomatous hypersensitivity to parasite egg. The antigens P-24, P-35 and P-97 were purified by affinity chromatography from a fraction of S. mansoni adult worm antigenic preparation, denominated PIII, involved in the inhibition of granulomatous response to eggs. Immunization of mice with these antigens, in the presence of Corynebacterium parvum and Al(OH)3 as adjuvant, induced a significant protection degree against challenge infection, as observed by the decrease on worm burden recovered from portal system. In vitro blastogenesis assays revealed that purified antigens were able to induce significant proliferation of spleen cells from S. mansoni-infected mice. This protection was correlated to significant decrease in granuloma size induced by PIII. From these results, we concluded that PIII preparation contains antigens capable of mediating protective anti-parasite immunity and down-regulating granulomatous hypersensitivity to S. mansoni eggs.

Diphtheria remains a threat to health in the developing world: an overview

Changes in the epidemiology of diphtheria are occurring worldwide. A large proportion of adults in many industrialized and developing countries are now susceptible to diphtheria. Vaccine-induced immunity wanes over time unless periodic booster is given or exposure to toxigenic Corynebacterium diphtheriae occurs. Immunity gap in adults coupled with large numbers of susceptible children creates the potential for new extensive epidemics. Epidemic emergencies may not be long in coming in countries experiencing rapid industrialization or undergoing sociopolitical instability where many of the factors thought to be important in producing epidemic such as mass population movements and difficult hygienic and economic conditions are present. The continuous circulation of toxigenic C. diphtheriae emphasizes the need to be aware of epidemiological features, clinical signs, and symptoms of diphtheria in vaccine era so that cases can be promptly diagnosed and treated, and further public health measures can be taken to contain this serious disease. This overview focused on worldwide data obtained from diphtheria with particular emphasis to main factors leading to recent epidemics, new clinical forms of C. diphtheriae infections, expression of virulence factors, other than toxin production, control strategies, and laboratory diagnosis procedures.

Microbiological and host features associated with corynebacteriosis in cancer patients: a five-year study

During a five-year period, 932 clinical isolates from cancer patients treated in a Brazilian reference centre were identified as corynebacteria; 86% of the cultures came from patients who had been clinically and microbiologically classified as infected and 77.1% of these patients had been hospitalised (71.1% from surgical wards). The adult solid tumour was the most common underlying malignant disease (66.7%). The univariate and multivariate analyses showed that hospitalised patients had a six-fold greater risk (OR = 5.5, 95% CI = 1.15-26.30 p = 0.033) related to 30-day mortality. The predominant species were Corynebacterium amycolatum (44.7%), Corynebacterium minutissimum (18.3%) and Corynebacterium pseudodiphtheriticum (8.5%). The upper urinary tracts, surgical wounds, lower respiratory tracts, ulcerated tumours and indwelling venous catheters were the most frequent sources of C. amycolatum strains. Corynebacterium jeikeium infection occurred primarily in neutropenic patients who have used venous catheters, while infection caused by C. amycolatum and other species emerged mainly in patients with solid tumours.

Identificação e controle com antibióticos de bactérias endofíticas contaminantes em explantes de batata micropropagados

Este trabalho teve por objetivos isolar, caracterizar e identificar bactérias endofíticas contaminantes encontradas em tecidos de batata durante a micropropagação e selecionar antibióticos para o controle in vitro desses microrganismos por meio da determinação da concentração bactericida mínima inibitória. Brotações de batata apresentando contaminação bacteriana durante a etapa de multiplicação in vitro, foram superficialmente esterilizadas e os internódios transferidos para placas de Petri com ágar nutriente, onde permaneceram incubadas a 28°C por até cinco dias. Após purificação, as bactérias foram caracterizadas e identificadas por testes taxonômicos. Um total de oito estirpes bacterianas foram isoladas e identificadas como pertencentes às famílias Acetobacteriaceae (1) e Enterobacteriaceae (2) e aos gêneros Corynebacterium (3), Pseudomonas (1) e Xanthomonas (1). Os melhores resultados para a inibição do crescimento bacteriano foram obtidos com os antibióticos ampicilina, cloranfenicol, estreptomicina e tetraciclina em concentrações que variaram de 32 a 256 mg L-1.

Improved diagnosis of periprosthetic joint infection by multiplex PCR of sonication fluid from removed implants.

The microbiological diagnosis of periprosthetic joint infection (PJI) is crucial for successful antimicrobial treatment. Cultures have limited sensitivity, especially in patients receiving antibiotics. We evaluated the value of multiplex PCR for detection of microbial DNA in sonication fluid from removed orthopedic prostheses. Cases of PJI in which the prosthesis (or part of it) was removed were prospectively included. The removed implant was sonicated, and the resulting sonication fluid was cultured and subjected to multiplex PCR. Of 37 PJI cases (17 hip prostheses, 14 knee prostheses, 4 shoulder prostheses, 1 elbow prosthesis, and 1 ankle prosthesis), pathogens were identified in periprosthetic tissue in 24 (65%) cases, in sonication fluid in 23 (62%) cases, and by multiplex PCR in 29 (78%) cases. The pathogen was detected in 5 cases in sonication fluid only (Propionibacterium acnes in all cases; none of these patients had previously received antibiotics) and in 11 cases by multiplex PCR only (all of these patients had previously received antibiotics). After exclusion of 8 cases caused by P. acnes or Corynebacterium species, which cannot be detected due to the absence of specific primers in the PCR kit, sonication cultures were positive in 17 cases and multiplex PCR sonication cultures were positive in 29 cases (59% versus 100%, respectively; P < 0.01). Among 19 cases (51%) receiving antibiotics, multiplex PCR was positive in all 19 (100%), whereas sonication cultures grew the organism in 8 (42%) (P < 0.01). Multiplex PCR of sonication fluid is a promising test for diagnosis of PJI, particularly in patients who previously received antibiotics. With modified primer sets, multiplex PCR has the potential for further improvement of the diagnosis of PJI.

Avaliação cinética da produção de biossurfactantes bacterianos

Biosurfactants present advantages in relation to the synthetic surfactants, as the biodegradability and low toxicity, and can be applied in the food industry, in pharmaceutical products, cosmetics and in the petroleum recovery. This paper aimed at selecting bacteria for biosurfactant production, evaluating the surface tension and the emulsifying activity and studying the fermentation process kinetics. The pure culture of Corynebacterium aquaticum showed capacity to promote emulsions formation and presented the smallest surface tension (28.8 mN m-1), and, in general, larger kinetic parameters, being selected as biosurfactant producer.

Meio de cultura semi-seletivo para detecção de Curtobacterium flaccumfaciens pv. flaccumfaciens em solo e sementes de feijoeiro

A murcha-de-curtobacterium, causada pela bactéria Curtobacterium flaccumfaciens pv. flaccumfaciens (Cff), é um importante problema para o cultivo de feijão (Phaseolus vulgaris L.) na região Centro-Sul do Brasil. A principal forma de disseminação da bactéria é por sementes contaminadas. Embora a ocorrência desta doença seja relativamente recente no Brasil, Cff tem sido disseminado rapidamente nas regiões produtoras de feijão do país. Este trabalho teve como objetivo ajustar o meio de cultura CNS (Corynebacterium Nebraskense Selective Medium) para recuperação e detecção de Cff em solo e sementes de feijoeiro. Suspensões provenientes da lavagem de amostras de solo e sementes contaminadas pela bactéria foram plaqueadas no meio de cultura CNS - modificado. Os ajustes realizados no meio de cultura possibilitaram a recuperação eficiente de Cff presente em solo e sementes contaminadas. As modificações estabelecidas para o meio CNS foram a redução da concentração de sulfato de polimixina para 16 mg/l, exclusão do componente ciclohexamida e substituição do fungicida Daconil 2787-F (530 mg/ml de chlorothalonil) pelo Dacostar 500 (500 mg/ml de chlorothalonil).

Perfil clínico e microbiológico de mulheres com vaginose bacteriana

OBJETIVO: estudar o perfil clínico e microbiológico de mulheres portadoras de vaginose bacteriana participantes de um ensaio clínico randomizado, duplamente mascarado, que comparou aroeira e metronidazol, em uso vaginal, para tratamento do corrimento genital. MÉTODOS: o estudo constitui-se em uma série de casos de 277 mulheres portadoras de vaginose bacteriana diagnosticada, concomitantemente, pelos critérios de Amsel e Nugent, selecionadas a partir de um total de 462 recrutadas, utilizando as informações colhidas antes da intervenção. A análise dos dados foi efetuada utilizando-se o programa Epi-Info 3.32. Para comparar as frequências dos desfechos entre os grupos de intervenção, foi utilizado o teste do χ2 e foi calculada a razão de risco e o intervalo de confiança a 95%. Foi feita análise por intenção de tratar. Além dos parâmetros de diagnósticos, foram também colhidas cultura do conteúdo vaginal e uma citologia de Papanicolaou. RESULTADOS: entre as queixas clínicas, as mais frequentes foram o corrimento genital, observado em 206 participantes (74,4%) e o odor de peixe da secreção vaginal, que ocorreu em 68,6% dos casos (190 pacientes). Dentre os critérios clínicos de diagnósticos, a presença de clue-cells foi positiva em 275 mulheres (99,3%), o teste de Whiff positivo apareceu em 266 participantes (96,0%), seguido do pH >4,5, que ocorreu em 92,8% dos casos e da presença de corrimento fluido e acinzentado, citado por 206 participantes (74,4%). Com relação ao critério de Nugent, a mediana dos escores foi o valor 8,0. As culturas de conteúdo vaginal permitiram a identificação de Gardnerella vaginalis em 96,8% e de Mobiluncus, em 53,1% dos casos. Apenas uma terça parte dos exames mostrou a presença de Lactobacillus (89 mulheres - 32,1%). Houve crescimento de fungos em culturas de 14 participantes (5,1%). Na maior parte dos casos, os resultados das culturas demonstraram a presença de Corynebacterium (94,2%), Cocos Gram-positivos (98,2%), além de bacilos Gram-positivos (99,3%) e negativos (91,0%). As colpocitologias oncóticas mostraram presença muito escassa de lactobacilos, que estiveram presentes em apenas 8 citologias (2,9%) do total de 273 exames realizados. CONCLUSÕES: os resultados do estudo não mostraram diferença em relação à literatura quanto aos sintomas referidos pelas mulheres, os critérios clínicos mais observados no diagnóstico, ou as espécies bacterianas demonstradas nas culturas de conteúdo vaginal. Os achados demonstram serem necessários novos estudos que melhor elucidem as inter-relações entre os achados microbiológicos e a expressão clínica da vaginose bacteriana. Registro do ensaio clínico: ISRCTN18987156