Capacidade antioxidante na Hb S: influência de talassemia alfa, haplótipos do gene βS globina e melatonina

Pós-graduação em Genética - IBILCE

Caracterização do genoma de tumores bem diferenciados da tireóide por hibridização genômica comparativa em matriz (aCGH)

Os tumores bem diferenciados da tireóide representam mais de 95% das neoplasias malignas da glândula. A identificação pré-operatória dos carcinomas papilíferos está bem estabelecida através dos métodos de Punção aspirativa por Agulha fina e Ultrassonografia, com quase 100% de acurácia, enquanto os tumores foliculares significam um dilema para o cirurgião, visto que os métodos existentes não conseguem determinar com eficiência o diagnóstico sendo que 60-80% dos casos operados são benignos. Dessa forma, com o intuito de se analisar alterações genômicas do tipo variações no número de cópias (CNVs) que possam diferenciar esse tumor de outros tipos de doenças da tireóide, foram analisados 13 pacientes com doença tireoidiana (3 bócios, 2 hiperplasias, 4 adenomas foliculares e 4 carcinomas foliculares ) mais 1 individuo sadio através do método de aCGH, para identificação de CNVs que pudessem determinar com eficiência a presença de carcinoma folicular. Os achados foram confrontados com dados de carcinomas papilífero clássico (4 pacientes) e variante folicular (2 pacientes). Foram encontradas 725 CNVs na amostra, 703 dos pacientes com patologia. Dentre estas foram selecionadas 18 regiões mais frequentes. Houve um padrão de amplificação maior em pacientes jovens com adenomas e deleção em pacientes mais velhos. Os pacientes com carcinoma apresentaram taxas de CNVs muito próximas. Os carcinomas foliculares apresentaram padrões exclusivos de alteração nos cromossomos 8 e 12. Concluímos, assim, que os carcinomas foliculares da tireoide são uma patologia com um padrão exclusivo de alterações, não havendo correlação de progressão tumoral a partir de adenomas foliculares, sendo que duas regiões -8p22 e 12p13.32-p13.33, estão presentes em 100% e 75% das amostras respectivamente, podendo ser fortes candidatos a marcadores desse tipo tumoral.

A magnetically drivable nanovehicle for curcumin with antioxidant capacity and MRI relaxation properties

Curcumin possesses wide-ranging anti-inflammatory and anti-cancer properties and its biological activity can be linked to its potent antioxidant capacity. Superparamagnetic maghemite (gamma-Fe2O3), called surface-active maghemite nanoparticles (SAMNs) were surface-modified with curcumin molecules, due to the presence of under-coordinated Fe-III atoms on the nanoparticle surface. The so-obtained curcumin-modified SAMNs (SAMN@curcumin) had a mean size of 13 +/- 4 nm. SAMN@curcumin was characterized by transmission and scanning electron microscopy, UV/Vis, FTIR, and Mossbauer spectroscopy, X-ray powder diffraction, bulk susceptibility (SQUID), and relaxometry measurements (MRI imaging). The high negative contrast proclivity of SAMN@curcumin to act as potential contrast agent in MRI screenings was also tested. Moreover, the redox properties of bound curcumin were probed by electrochemistry. SAMN@curcumin was studied in the presence of different electroactive molecules, namely hydroquinone, NADH and ferrocyanide, to assess its redox behavior. Finally, SAMN@curcumin was electrochemically probed in the presence of hydrogen peroxide, demonstrating the stability and reactivity of bound curcumin.

Desenvolvimento de métodos analíticos de desreplicação por RMN, EM e análise multivariada do perfil metabolômico de espécies de Solanaceae com potencial biológico

Pós-graduação em Química - IQ

Triagem interventiva: a caracterização de uma demanda

This paper analyzes the process of sorting through the intervening demand survey that reaches the Center for Research and Applied Psychology (CPPA) “Dr. Betti Katzenstein” UNESP Assis. The objective was to better understand the reality of conflicts that people face and, therefore, to characterize the patients who seek help in CPPA. With greater understanding of demand, it is possible to trace more consistent referrals and tailor the service to the school clinic profile of clients that demand. Recalling that the actual attendance of screening is already a form of interventional care, because it provides patient care from first contact. This was a documentary research, which had collected their data sheets of the CPPA trials conducted in 2011. 394 screenings were performed. We present the distribution of the demand for sex, age and complaint that motivated the search for care. It can be concluded that the characterization allows a customer routing more efficient services offered at the institution, as it contributes to a better understanding delineated in each case and a reduced number of dropouts in the screening process.

A kinetic study of the main guaco metabolites using syrup formulation and the identification of an alternative route of coumarin metabolism in humans

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Development of an Electrochemical Insulin Sensor Based on a High Affinity DNA Sequence Found in the Insulin-linked Polymorphic Region

The detection of pertinent biomarkers has the potential provide an early indication of disease progression before considerable damage has been incurred. A decrease in an individual’s sensitivity to insulin, which may be quantified as the ratio of insulin to glucose in the blood after a glucose pulse, has recently been reported as an early predictor of insulin-dependent diabetes mellitus. Routine measurement of insulin levels is therefore desirable in the care of diabetes-prone individuals. A rapid, simple, and reagentless method for insulin detection would allow for wide-spread screenings that provide earlier signs of diabetes onset. The aim of this thesis is to develop a folding-base electrochemical sensor for the detection of insulin. The sensor described herein consists of a DNA probe immobilized on a gold disc electrode via an alkanethiol linker and embedded in an alkanethiol self-assembled monolayer. The probe is labeled with a redox reporter, which readily transfers electrons to the gold electrode in the absence of insulin. In the presence of insulin, electron transfer is inhibited, presumably due to a binding-induced conformational or dynamic change in the DNA probe that significantly alters the electron-tunneling pathway. A 28-base segment of the insulin-linked polymorphic region that has been reported to bind insulin with high affinity serves as the capture element of the DNA probe. Three probe constructs that vary in their secondary structure and position of the redox label are evaluated for their utility as insulin-sensing elements on the electrochemical platform. The effects of probe modification on secondary structure are also evaluated using circular dichroism spectroscopy.

Do ciberespaço à iconomia: projeções metapóricas

Na sociedade contemporânea o ser humano se vê inserido – ou invadido – em ambientes cada vez mais configurados por complexos recursos tecnológicos. É o ciberespaço, onde as imagens inundam o cotidiano e se traduzem em valor, o corpo adquire novo status imaterial e as noções de lugar e tempo se transformam e quase se anulam. O cinema pensa e produz também uma desterritorialização da imagem em movimento desde os seus primeiros tempos de imagem-máquina. Este trabalho reflete sobre as transformações da ordem social que implicam a emergência de uma “iconomia” a partir dos espaços simbólicos, tomando três momentos críticos na história do cinema como índices de uma convergência entre material e imaterial que se consolida a partir da emergência do ciberespaço. O quase-método metapórico é mobilizado como ferramenta de reconstrução metodológica desses ícones da história do cinema relacionados à desconstrução do Homo faber. O “outro lado” do ciberespaço, abrindo continuamente novos espaços-tempos de criação de valor, identifica-se a uma iconomia em que as projeções narrativas tornam-se fontes paradigmáticas de valor e de “mais gozar”.

Base-Paired and Base-Stacked Structures of the Anti-HIV Drug Lamivudine: A Nucleoside DNA-Mimicry with Unprecedented Topology

We have prepared a DNA-mimicry of nucleosides in which the anti-HIV drug lamivudine (beta-L-2',3'-dideoxy-3'-thiacytidine, 3TC) self-assembles into a base-paired and helically base-stacked hexagonal structure. Face-to-face and face-to-tail stacked 3TC=3TC dimers base-paired through two hydrogen bonds between neutral cytosines by either N-H center dot center dot center dot O or N-H center dot center dot center dot N atoms give rise to a right-handed DNA-mimicry of lamivudine with an unusual highly symmetric hexagonal lattice and topology. In addition, a base-paired and base-stacked supramolecular architecture of lamivudine hemihydrochloride hemihydrate was also obtained as a result of our crystal screenings. This structure is formed through partially face-to-face stacked lamivudine pairs held together by protonated and neutral fragments. However, no helical stacking occurs in this structure in which lamivudine also adopts unusual conformations as the C1'-endo and C1'-exo sugar puckers and cytosine orientations intermediate between the anti and syn conformations. As a conclusion drawn from the nucleoside duplex, the hexagonal DNA-mimicry of lamivudine reveals that such double-stranded helices can be assembled without counterions and organic solvents but with higher crystallographic symmetry instead, because only water crystallizes together with lamivudine in this structure.

Wilson's disease: an analysis of 28 Brazilian children

OBJECTIVES: Clinical-laboratory and evolutionary analysis of twenty-eight patients with Wilson's disease. METHODS: Twenty-eight children (twelve females and sixteen males) with Wilson's disease were evaluated retrospectively between 1987 and 2009, with a follow-up of 72 months (1 -240 months). The clinical, laboratory, and histologic features at diagnosis were recorded at the end of the study. RESULTS: The median age at diagnosis was 11 years (2 -18 years). Twelve patients were asymptomatic, seven had hepatitis symptoms, five had raised aminotransferase levels, three had hepatomegaly associated with neurological disorders, one had fulminant hepatitis with hemolytic anemia, and six patients presented with a Kayser-Fleischer ring. A histological analysis revealed that six children had chronic hepatitis, seven had cirrhosis, two had steatosis, one had portal fibrosis, and one had massive necrosis. The treatment consisted of D-penicillamine associated with pyridoxine for 26 patients. Adverse effects were observed in the other two patients: one presented with uncontrollable vomiting and the other demonstrated elastosis perforans serpiginosa. At the end of the study, all 26 treated patients were asymptomatic. Twenty-four of the patients were treated with D-penicillamine and pyridoxine, and two were treated with trientine and zinc sulfate. A liver transplant was performed in one patient with fulminant hepatitis, but the final patient died 48 hours after admission to the intensive care unit. CONCLUSIONS: Family screenings associated with early treatment are important in preventing Wilson's disease symptoms and potentially fatal disease progression. The study suggests that Wilson's disease must be ruled out in children older than two years presenting with abnormal levels of hepatic enzymes because of the heterogeneity of symptoms and the encouraging treatment results obtained so far.

Anticancer drug screening from images of zebrafish embryogenesis

During the previous 10 years, global R&D expenditure in the pharmaceuticals and biotechnology sector has steadily increased, without a corresponding increase in output of new medicines. To address this situation, the biopharmaceutical industry's greatest need is to predict the failures at the earliest possible stage of the drug development process. A major key to reducing failures in drug screenings is the development and use of preclinical models that are more predictive of efficacy and safety in clinical trials. Further, relevant animal models are needed to allow a wider testing of novel hypotheses. Key to this is the developing, refining, and validating of complex animal models that directly link therapeutic targets to the phenotype of disease, allowing earlier prediction of human response to medicines and identification of safety biomarkers. Morehover, well-designed animal studies are essential to bridge the gap between test in cell cultures and people. Zebrafish is emerging, complementary to other models, as a powerful system for cancer studies and drugs discovery. We aim to investigate this research area designing a new preclinical cancer model based on the in vivo imaging of zebrafish embryogenesis. Technological advances in imaging have made it feasible to acquire nondestructive in vivo images of fluorescently labeled structures, such as cell nuclei and membranes, throughout early Zebrafishsh embryogenesis. This In vivo image-based investigation provides measurements for a large number of features at cellular level and events including nuclei movements, cells counting, and mitosis detection, thereby enabling the estimation of more significant parameters such as proliferation rate, highly relevant for investigating anticancer drug effects. In this work, we designed a standardized procedure for accessing drug activity at the cellular level in live zebrafish embryos. The procedure includes methodologies and tools that combine imaging and fully automated measurements of embryonic cell proliferation rate. We achieved proliferation rate estimation through the automatic classification and density measurement of epithelial enveloping layer and deep layer cells. Automatic embryonic cells classification provides the bases to measure the variability of relevant parameters, such as cell density, in different classes of cells and is finalized to the estimation of efficacy and selectivity of anticancer drugs. Through these methodologies we were able to evaluate and to measure in vivo the therapeutic potential and overall toxicity of Dbait and Irinotecan anticancer molecules. Results achieved on these anticancer molecules are presented and discussed; furthermore, extensive accuracy measurements are provided to investigate the robustness of the proposed procedure. Altogether, these observations indicate that zebrafish embryo can be a useful and cost-effective alternative to some mammalian models for the preclinical test of anticancer drugs and it might also provides, in the near future, opportunities to accelerate the process of drug discovery.

Design, Synthese und biologische Evaluierung von Pyrrolcarboxamiden mit Nucleobasen- oder tricyclischer Aromatenfunktion

Ausgehend von den Naturstoffen Netropsin und Distamycin A, antitumoraktiven Pyrrolcarboxamiden, die selektiv an AT-reiche Sequenzen in der kleinen Rinne (Minor-Groove) der DNA binden, sollten neue Nucleobasen- bzw. Interkalator-gekoppelte Derivate (letztere werden als „Combilexine“ bezeichnet) synthetisiert und biologisch evaluiert werden. Unter Zuhilfenahme quantenchemischer AM1-Rechnungen sollten Struktur-Wirkungs-Beziehungen abgeleitet werden. Als Grundgerüst diente die Mono- bzw. Bispyrrolcarboxamid-Einheit mit C-terminaler N,N-Dimethyl-1,3-diaminopropan-Seitenkette, die die ebenfalls basische Amidinstruktur der Leitsubstanzen imitieren sollte. Variationen erfolgten ausschließlich am N-terminalen Ende. Hierbei wurden zunächst Adenin-, Thymin- und Uracil-alkancarbonsäuren mit variabler Kettenlänge synthetisiert und über verschiedene Amidkupplungsverfahren an die Aminofunktion des Pyrrolcarboxamid-Grundgerüstes geknüpft. In Analogie hierzu folgte die Synthese von Combilexinen mit Acridon, (Nitro-)Naphthalimid und Iminostilben als Interkalatorkomponenten. Im 3. synthetischen Teil der Arbeit wurden Carbonsäure- und Sulfonylchloride des Interkalators Acridin und des Interkalators und Photosensibilisators Anthrachinon über die aliphatischen Linker ß-Alanin und -Aminobuttersäure an das Pyrrolcarboxamidgrundgerüst gebunden. Testungen von Verbindungen aller 3 Serien auf Zytotoxizität beim National Cancer Institute, USA, und DNA-Bindestudien und Topoisomerase-Hemmtests im Laboratory of Pharmacology, INSERM in Lille, Frankreich, schlossen sich an. Bei allen Verbindungen mit mindestens 3 Carboxamid-Funktionen zeigte sich gute bis ausgezeichnete DNA-Bindung; einige wiesen Topoisomerase II - Hemmung auf. Beide Parameter korrelierten allerdings nicht mit der Zytotoxizität, was vor allem an der mangelhaften Zellmembranpermeation einiger Verbindungen aufgrund zu geringer Lipophilie liegen dürfte. Quantenchemische Rechnungen ergaben ebenfalls wenige Gesetzmäßigkeiten. Ein elektronenarmer N-terminaler Rest (wie im Falle des hochpotenten Iminostilben-Derivates) scheint aber die Zytotoxizität einer Substanz ebenso wie zunehmende Linkerlänge zu begünstigen. Eine Ausnahme bilden hier die Anthrachinonderivate. Die drei zytotoxisch aktivsten Vertreter dieser Gruppe besitzen als Linker ß-Alanin, was eine aus der sonst bei Minor-Groove-Bindern üblichen Kurvature herausragende Konformation zur Folge hat. Diese ermöglicht vermutlich eine besonders gute Interaktion mit der DNA.

Bioinformatische Identifizierung und Charakterisierung von Zyklin-abhängigen Kinasen und Zyklinen des Parasiten Eimeria tenella und deren Nutzung im rationalen Wirkstoffdesign

Parasiten der Apicomplexa umfassen sowohl humanpathogene, als auch tierpathogene Protozoen. Beispiele für wichtige Vertreter human- und tierpathogener Parasiten sind Plasmodium falciparum und Eimeria tenella. E. tenella verursacht die Kokzidiose des Hühnchens, eine Darmerkrankung die weltweit für Verluste in einer geschätzten Höhe von bis zu 3 Milliarden US$ verantwortlich zeichnet. Eine prophylaktische Vakzinierung gegen diese Krankheit ist ökonomisch meist ineffizient, und eine Behandlung mit Kokzidiostatika wird durch häufige Resistenzbildung gegen bekannte Wirkstoffe erschwert. Diese Situation erfordert die Entwicklung neuer kostengünstiger Alternativen. Geeignete Zielproteine für die Entwicklung neuartiger Arzneistoffe zur Behandlung der Kokzidiose sind die Zyklin-abhängigen Kinasen (CDKs), zu denen auch die CDK-related Kinase 2 (EtCRK2) aus E. tenella gehört. Diese Proteine sind maßgeblich an der Regulation des Zellzyklus beteiligt. Durch chemische Validierung mit dem CDK Inhibitor Flavopiridol konnte nachgewiesen werden, dass ein Funktionsverlust von CDKs in E. tenella die Vermehrung des Parasiten in Zellkultur inhibiert. E. tenella CDKs sind daher als Zielproteine für die Entwicklung einer Chemotherapie der Kokzidiose geeignet. Mittels bioinformatischer Tiefenanalysen sollten CDK Proteine im Parasiten E. tenella identifiziert werden. Das Genom von E. tenella liegt in Rohfassung vor [ftp://ftp.sanger.ac.uk]. Jedoch waren zum Zeitpunkt dieser Arbeiten viele Sequenzen des Genoms noch nicht annotiert. Homologe CDK Proteine von E. tenella konnten durch den Vergleich von Sequenzinformationen mit anderen Organismen der Apicomplexa identifiziert und analysiert werden. Durch diese Analysen konnten neben der bereits bekannten EtCRK2, drei weitere, bislang nicht annotierte CDKs in E. tenella identifiziert werden (EtCRK1, EtCRK3 sowie EtMRK). Darüber hinaus wurde eine Analyse der entsprechenden Zykline – der Aktivatoren der CDKs – bezüglich Funktion und Struktur, sowie eine Datenbanksuche nach bisher nicht beschriebenen Zyklinen in E. tenella durchgeführt. Diese Suchen ergaben vier neue potentielle Zykline für E. tenella, wovon EtCYC3a als Aktivator der EtCRK2 von María L. Suárez Fernández (Intervet Innovation GmbH, Schwabenheim) bestätigt werden konnte. Sequenzvergleiche lassen vermuten, dass auch EtCYC1 und EtCYC3b in der Lage sind, EtCRK2 zu aktivieren. Außerdem ist anzunehmen, dass EtCYC4 als Aktivator der EtCRK1 fungiert. Ein weiterer Schwerpunkt der vorliegenden Arbeit war die Suche und Optimierung nach neuen Inhibitoren von CDKs aus E. tenella. In vorangegangenen Arbeiten konnten bereits Inhibitoren der EtCRK2 gefunden werden [BEYER, 2007]. Mittels Substruktur- und Ähnlichkeitssuchen konnten im Rahmen dieser Arbeit weitere Inhibitoren der EtCRK2 identifiziert werden. Vier dieser Strukturklassen erfüllen die Kriterien einer Leitstruktur. Eine dieser Leitstrukturen gehört zur Strukturklasse der Benzimidazol-Carbonitrile und ist bislang nicht als Inhibitor anderer Kinasen beschrieben. Diese neu identifizierte Leitstruktur konnte in silico weiter optimiert werden. Im Rahmen dieser Arbeit wurden Bindungsenergien von Vertretern dieser Strukturklasse berechnet, um einen wahrscheinlichen Bindemodus vorherzusagen. Für die weiterführende in silico Optimierung wurde eine virtuelle kombinatorische Substanzbibliothek dieser Klasse erstellt. Die Auswahl geeigneter Verbindungen für eine chemische Synthese erfolgte durch molekulares Docking unter Nutzung von Homologiemodellen der EtCRK2. Darüber hinaus wurde ein in silico Screening nach potentiellen Inhibitoren der PfMRK und EtMRK durchgeführt. Dabei konnten weitere interessante virtuelle Hit-Strukturen aus einer Substanzdatenbank kommerziell erhältlicher Verbindungen gefunden werden. Durch dieses virtuelle Screening konnten jeweils sieben Verbindungen als virtuelle Hits der PfMRK sowie der EtMRK identifiziert werden. Die Häufung von Strukturklassen mit bekannter CDK Aktivität deutet darauf hin, dass während des virtuellen Screenings eine Anreicherung von CDK Inhibitoren stattgefunden hat. Diese Ergebnisse lassen auf eine Weiterentwicklung neuer Wirkstoffe gegen Kokzidiose und Malaria hoffen.

Characterization of the Caspr2 and NLGN2 ligands: a proteomic and biochemical approach

Autism Spectrum Disorder (ASD) is a range of early-onset conditions classified as neurodevelopmental disorders, characterized by deficits in social interactions and communication, as well as by restricted interest and repetitive behaviors. Among the proteins associated with this spectrum of disease there are Caspr2, α-NRXN1, NLGN1-4. Caspr2 is involved in the clustering of K+ channels at the juxtaparanodes, where it is proposed to bind TAG-1. Recent works reported a synaptic localization of Caspr2, but little is know on its role in this compartment. NRXNs and their ligand NLGNs, instead, have a well-defined role in the formation and maintenance of synapses. Among the neuroligins, NLGN2 binds NRXNs with the lowest affinity, suggesting that it could have other not yet characterized ligands. The aim of this work was to better characterize the binding of Caspr2 to TAG-1 and to identify new potential binding partner for Caspr2 and NLGN2. Unexpectedly, using Isothermal Titration Calorimetry and co-immunoprecipitation experiments the direct association of the first two proteins could not be verified and the results indicate that the first evidences reporting it were biased by false-positive artifacts. These findings, together with the uncharacterized synaptic localization of Caspr2, made the identification of new potential binding partners for this protein necessary. To find new proteins that associate with Caspr2 and NLGN2, affinity chromatography in tandem with mass spectrometry experiments were performed. Interestingly, about 25 new potential partners were found for these two proteins and NLGN1, that was originally included as a control: 5 of those, namely SFRP1, CLU, APOE, CNTN1 and TNR, were selected for further investigations. Only the association of CLU to NLGN2 was confirmed. In the future, screenings of the remaining candidates have to be carried out and the functional role for the proposed NLGN2-CLU complex has to be studied.

Molekulare Epidemiologie von MRSA-Patienten-Isolaten

MRSA ist der wohl bekannteste nosokomiale Infektionserreger weltweit. Die aktuelle Situation ist aufgrund der schnellen Ausbreitung, vor allem von caMRSA, in einigen Ländern besorgniserregend. Für den Raum Mainz konnte innerhalb der fünf Untersuchungsjahre eine stabile Populationsstruktur nachgewiesen werden, welche hauptsächlich aus deutschlandweit bekannten Epidemiestämmen gebildet wird. Als Besonderheit ergab sich die Dominanz des spa-Typs t003 (> 70 %), sowie das Vorherrschen hoch klonaler Strukturen an UMM und KKM. Diese Umstände lassen auf eine weite Verbreitung von MRSA, speziell des spa-Typs t003, innerhalb der Bevölkerung schließen. Die Bestätigung dieser Vermutung bedarf jedoch weiterer prospektiver Forschung außerhalb der Kliniken.rnAn der UMM konnte im Untersuchungszeitraum 2004-2008 keine Zunahme von klassischen PVL-positiven caMRSA (t008, t019 und t044) festgestellt werden, womit zumindest momentan noch keine Verdrängung von haMRSA durch caMRSA belegt werden konnte.rnDie von WITTE et al. (2004) postulierte 5 % Grenze für den häufigsten detektierten Typ einer Typisierungsmethode muss dahingehend modifiziert werden, dass diese Bedingung zwar allgemein für ein Typisierungsverfahren, nicht aber für lokale Populationen gelten sollte. Im Falle des Vorherrschens klonaler Linien und Subtypen würde keine Methode ausreichend diskriminatorische Eigenschaften aufweisen.rnDie Kombination von spa-Typisierung und PFGE konnte, mit Einschränkungen für den vorherrschenden t003, als geeignet im Falle der Keimdifferenzierung während eines Ausbruchs befunden werden. Als vorteilig für die Interpretation würde sich die Einführung eines generellen MRSA-Screenings für jeden Patienten bei Aufnahme auswirken.rnDie Überprüfung der Thesen von FRÉNAY et al. 1994 ergab keinen Zusammenhang zwischen einer X-Region ≥ 8 Repeats und einem erhöhtem Virulenzpotential. Bezüglich des gesteigerten epidemischen Potentials wurde festgestellt, dass lange X-Regionen generell häufiger auftreten als kurze und somit ein begünstigender Einfluss bei der Kolonisation vermutet aber nicht bewiesen werden kann.rnFür die Detektion von klassischen caMRSA konnte ein Ablaufschema mit Interpretationsrichtlinien erarbeitet werden, welches eine korrekte Differenzierung auch ohne die Einbeziehung patientenbezogener Daten ermöglicht. Die Anlage einer lokalen PFGE-Datenbank zeigte sich dabei als unbedingt notwendig um strittige Fälle als ha- oder caMRSA einzuordnen.rn