Small hospitals matter: insights from the emergence and spread of vancomycin-resistant enterococci in 2 public hospitals in inner Brazil

Although vancomycin-resistant enterococci (VRE) are reported in Brazil since 1996, data on their impact over settings of different complexity are scarce. We performed a study aimed at identifying determinants ofVRE emergence and spread in a public hospital consortium (comprising 2 hospitals, with 318 and 57 beds) in inner Brazil. Molecular typing and case-control studies (addressing predictors of acquisition or clonality) were performed. Among 122 authocthonous isolates, 106 were Enterococcus faecium (22 clones), and 16, Enterococcus faecalis (5 clones). Incidence was greater in the small-sized hospital, and a previous admission to this hospital was associated with greater risk of VRE colonization or infection during admission to the larger one. Overall risk factors included comorbidities, procedures, and antimicrobials (piperacillin-tazobactam, cefepime, and imipenem). Risk factors varied among different hospitals, species, and clones. Our findings demonstrate that VRE can spread within low-complexity facilities and from these to larger hospitals. (C) 2015 Elsevier Inc. All rights reserved.

Diversity of Lactic Acid Bacteria Isolated from Brazilian Water Buffalo Mozzarella Cheese

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

Microbiological Profile Resistant to Different Intracanal Medications in Primary Endodontic Infections

Introduction: This clinical study aimed to determine the microbiological profile resistant to different intracanal medications in primary endodontic infections by using both microbiological culture and the checkerboard DNA-DNA hybridization technique. Methods: Twenty primarily infected root canals were selected and then instrumented before being randomly divided into 2 groups according to the intracanal medications: calcium hydroxide (Ca[OH](2)) or Ca(OH)(2) + chlorhexidine (CHX). Samples were collected before and after root canal procedures, which consisted in submitting them to microbiological culture and processing them for checkerboard DNA-DNA hybridization. Results: No differences were found between the Ca(OH)(2) (99.98%) and Ca(OH)(2) + CHX groups (99.76%) regarding the median percentage values for the reduction of cultivable bacteria. The most frequently detected species were Capnocytophaga ochracea (70%) and Fusobacterium nucleatum ssp. vincentii (70%) in the initial samples. After instrumentation, the most frequently detected species were E. faecium (60%). After root canal treatments using either Ca(OH)(2) or Ca(OH)(2) + CHX as intracanal medications, the most frequently detected species were E nucleatum ssp. vincentii (90%) and Enterococcus faecium (40%), respectively. Both treatments significantly decreased the number of bacterial species compared with the initial sample. However, this reduction was significantly greater in the Ca(OH)(2) + CHX group (P < .05). This difference was also observed when evaluating the total bacterial load (P < .05). Conclusions: The use of Ca(OH)(2) associated with CHX as an intracanal medication showed better results by acting on gram-positive and gram-negative microorganisms although such an action to eradicate enterococci should also be sought.

Efficacy of prebiotics, probiotics, and synbiotics on laying hens and broilers challenged with salmonella enteritidis

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Use of probiotics to reduce faecal shedding of Shiga toxin-producing Escherichia coli in sheep

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

Isoflavones supplementation of a probiotic soy product: effects on quality characteristics and isoflavones profile

The aim of the present study was to investigate the effect of isofl avones supplementation of a fermented soy product on its sensory acceptance, physicochemical properties and probiotic cell viable count. Additionally we also investigated the ability of the mixed starter cultures (Enterococcus faecium CRL 183 and Lactobacillus helveticus 416) to modify the isofl avones profi le of soy product during the fermentation process. Three products were analysed: soy product fermented with E. faecium CRL 183 and L. helveticus 416, isofl avonessupplemented soy product (fermented with E. faecium CRL 183 and L. helveticus 416; 50mg/100g, Isofl avin®, Galena, Brazil) and unfermented soy product. A panel of judges evaluated the acceptability of the samples on a nine point structured hedonic scale. The chemical composition namely fat, protein, ash and total carbohydrate contents, pH, enumeration of viable Lactobacillus spp. and Enterococcus spp. and quantifi cation of isofl avones using HPLC were investigated. All determinations were conducted after 7 days storage at 10°C. The sensorial acceptance was reduced in the isofl avones-supplemented soy product, but this effect was not signifi cant compared to the sample without isofl avones addition. Chemical composition did not differ (p<0.05) among the samples. Cell viable counts were reduced and total fermentation time was longer in the isofl avonessupplemented soy product, suggesting that the isofl avone addition could inhibit the starter cultures. However, all the products may be considered probiotic since they exhibited lactic acid bacterial populations varying from 2.3 x 109 up to 1.22 x 1010 CFU/mL. Fermentation of soymilk did not change the isofl avones profi le. In conclusion, it was possible to obtain a fermented soy product containing a high isofl avones concentration, adequate sensory and chemical characteristics and lactic acid bacterial viability suffi ciently high to characterize the product as a probiotic. The mixed starter culture was not able to convert the glycoside isofl avones into aglycone or produce equol during the fermented soy product processing.

Influence of a probiotic soy product on fecal microbiota and its association with cardiovascular risk factors in a animal model

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

Desenvolvimento de um embutido cárneo fermentado, com teores reduzidos de gordura e sais de cura, através da utilização de culturas probióticas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Desenvolvimento de pastilha potencialmente probiótica

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Sardinian goat's milk as source of bacteriocinogenic potential protective cultures

Goat breeding in Sardinia constitutes an important source of income for farming and shepherding activities. In this study 170 LAB strains were isolated from Sardinian goat's milk and tested for bacteriocins production against several food-borne pathogenic microorganisms. Four isolates (SD1, SD2, SD3 and SD4) were selected for their effective inhibition on Listeria monocytogenes. The strains were classified as members of Enterococcus genus, according to their biochemical and physiological characteristics, and then genetically identified as Enterococcus faecium. In MRS broth at 37 degrees C, bacteriocins SD1 and SD2 were produced at much higher levels (51200 AU/ml) compared to bacteriocin SD3 (3200 AU/ml) and bacteriocin SD4 (800 AU/ml). Their peptides were inactivated by proteolytic enzymes, but not when treated with alpha-amylase, catalase and lipase. The four bacteriocins remained stable at pH from 2.0 to 12.0, after exposure to 100 degrees C for 120 min and were not affected by the presence of surfactants and salts (N-Laourylsarcosine, NaCl, SDS, Triton X-100, Tween 20, Tween 80 and urea). Their molecular size was determined to be approximately 5 kDa by tricine-SDS-PAGE. Since the strains exhibited a strong antimicrobial activity against 21 L monocytogenes strains and 6 Salmonella spp. isolates, they should be considered as potential bio-preservatives cultures for fermented food productions. Moreover, due to their technological features, the four strains could be taken in account for using as adjunct NSLAB (non-starter lactic acid bacteria) rather than as starter culture. (C) 2011 Elsevier Ltd. All rights reserved.

In Vitro Evaluation of the Probiotic Potential of Bacteriocin Producer Lactobacillus sakei 1

Lactobacillus sakei 1 is a food isolate that produces a heat-stable antimicrobial peptide (sakacin 1, a class ha bacteriocin) inhibitory to the opportunistic pathogen Listeria monocytogenes. Bacterial isolates with antimicrobial activity may be useful for food biopreservation and also for developing probiotics. To evaluate the probiotic potential of L. sakei I, it was tested for (i) in vitro gastric resistance (with synthetic gastric juice adjusted to pH 2.0, 2.5, or 3.0); (ii) survival and bacteriocin production in the presence of bile salts and commercial prebiotics (inulin and oligofructose); (iii) adhesion to Caco-2 cells; and (iv) effect on the adhesion of L. monocytogenes to Caco-2 cells and invasion of these cells by the organism. The results showed that L. sakei I survival in gastric environment varied according to pH, with the maximum survival achieved at pH 3.0, despite a 4-log reduction of the population after 3 h. Regarding the bile salt tolerance and influence of prebiotics, it was observed that L. sakei 1 survival rates were similar (P > 0.05) for all de Man Rogosa Shame (MRS) broth formulations when tests were done after 4 h of incubation. However, after incubation for 24 h, the survival of L. sakei 1 in MRS broth was reduced by 1.8 log (P < 0.001), when glucose was replaced by either inulin or oligofructose (without Oxgall). L. sakei 1 was unable to deconjugate bile salts, and there was a significant decrease (1.4 log) of the L. sakei 1 population in regular MRS broth plus Oxgall (P < 0.05). In spite of this, tolerance levels of L. sakei 1 to bile salts were similar in regular MRS broth and in MRS broth with oligofructose. Lower bacteriocin production was observed in MRS broth when inulin (3,200 AU/ml) or oligofructose (2,400 AU/ml) was used instead of glucose (6,400 AU/ml). L. sakei I adhered to Caco-2 cells, and its cell-free pH-neutralized supernatant containing sakacin I led to a significant reduction of in vitro listerial invasion of human intestinal Caco-2 cells.

Studio della maturazione di formaggi pecorino stagionati in stabilimento e in grotta

Aims: Ripening evaluation of two different Pecorino cheese varieties ripened according either to a traditional method in plant and in cave. Different ripening features have been analyzed in order to evaluate the cave as possible ripening environment with the aim of obtaining a peculiar product which could also establish an added value to the cultural heritage of the local place in which it has been originally manufactured. Methods and Results: Chemical-physical features of Pecorino cheese have been initially analyzed into two different ripening environments and experimentations, among which: pH, weight reduction and subsequent water activity. Furthermore, the microbial composition has been characterized in relationship with the two different ripening environments, undertaking a variety of microbial groups, such as: lactic bacteria, staphylococci, yeasts, lactococci, enterobacteria, enterococci. Besides, an additional analysis for the in-cave adaptability evaluation has been the identification of biogenic amines inside the Pecorino cheese (2-phenilethylamine, putrescine, cadaverine, hystidine, tyramine, spermine and spermidine). Further analysis were undertaken in order to track the lipid profile evolution, reporting the concentration of the cheese free fatty acids in object, in relation with ripening time, environment and production. In order to analyse the flavour compounds present in Pecorino cheese, the SPME-GC-MS technique has been widely employed. As a result, it is confirmed the trend showed by the short-chain free fatty acids, that is to say the fatty acids which are mostly involved in conveying a stronger flavor to the cheese. With the purpose of assessing the protheolytic patterns of the above-mentioned Pecorino cheese in the two different ripening environments and testing methods, the technique SDS-PAGE has been employed into the cheese insoluble fraction, whereas the SDS-PAGE technique has been carried out into the cheese soluble portion. Furthermore, different isolated belonging to various microbial groups have been genotypically characterized though the ITS-PCR technique with the aim to identify the membership species. With reference to lactic bacillus the characterized species are: Lactobacillus brevis, Lactobacillus curvatus and Lactobacillus paraplantarum. With reference to lactococci the predominant species is Lactococcus lactis, coming from the employed starter used in the cheese manufacturing. With reference to enterococcus, the predominant species are Enterococcus faecium and Enterococcus faecalis. Moreover, Streptococcus termophilus and Streptococcus macedonicus have been identified too. For staphylococci the identified species are Staphyilococcus equorum, Staphylococcus saprophyfiticus and Staphylococcus xylosus. Finally, a sensorial analysis has been undertaken through on one side a consumer test made by inexperienced consumers, and on the other side through a panel test achieved by expert consumers. From such test Pecorino cheese ripened in cave were found to be more pleasant in comparison with Pecorino cheese ripened in plant. Conclusions: The proposed approach and the undertaken analysis showed the cave as preferential ripening environment for Pecorino cheese and for the development of a more palatable product and safer for consumers’ health.

Rilievi anatomo-patologici e batteriologici condotti sull’apparato gastroenterico di una metapopolazione di cinghiali (Sus scrofa)

Nell’ambito della patologia gastroenterica del suino sono comprese alcune malattie sostenute da batteri spirillari gram negativi, di cui sono disponibili numerose trattazioni riguardanti, soprattutto, l'aspetto epidemiologico e patogenetico. Per alcuni di questi agenti microbici, e per le relative manifestazioni patologiche, poco si conosce nel cinghiale selvatico, animale correlato filogeneticamente al suino domestico, ma compreso in un’ecologia completamente differente. Da queste premesse è nato un approccio di ricerca e studio del comportamento di questi microrganismi in una metapopolazione di cinghiali, abbattuti durante il piano di controllo della popolazione densità-dipendente nel Parco dei Gessi e Calanchi dell’Abbadessa (BO), cercando di rapportare le conoscenze riportate in letteratura sul suino domestico con quanto è scaturito dalle indagini condotte sul cinghiale selvatico. In particolare è stata indagata con metodica immunoistochimica la presenza di Lawsonia intracellularis, patogeno del suino responsabile di Enterite Proliferativa (EP), in secondo luogo sono state condotte indagini batteriologiche e istologiche da stomaco e intestino, finalizzate all’isolamento di microrganismi spirillari dei generi Campylobacter e Helicobacter, da correlare all’eventuale presenza di lesioni infiammatorie e ulcerative gastriche o enteriche valutate secondo sistemi a punteggio ottenuti dalla bibliografia o realizzati in base alla tipologia di infiltrato cellulare e alla sua localizzazione. In ultimo, a fini comparativi con uno studio condotto nel 2002-2004 nello steso Parco Regionale, sono stati monitorati i livelli di antibioticoresistenza di indicatori fecali usando metodiche internazionali standardizzate (Escherichia coli e Enterococcus faecium.) nonché su un numero significativo di isolati di Campylobacter lanienae, per ottenere indicazioni preliminari sull’andamento nei 10 anni trascorsi dello stato di inquinamento da farmaco del Parco stesso. I risultati ottenuti permettono di ampliare le conoscenze sulla flora enterica del cinghiale selvatico e pongono questioni di sicurezza pubblica sulla gestione dei mammiferi selvatici.

Vancomycin-resistente Enterokokken (VRE) bei Patienten und in der aquatischen Umwelt

Vancomycin-resistente Enterokokken (VRE) treten als Erreger von nosokomialen Infektionen immer häufiger auf und schränken die Therapiemöglichkeiten deutlich ein. In den eigenen Untersuchungen wurde das Vorkommen von Vancomycin-resistenten Enterococcus faecium (VREf) bei Patienten und in der aquatischen Umwelt (Abwasser und Oberflächenwasser) über einen Zeitraum von sechs Jahren (2004 bis 2009) untersucht. Eine Genotypisierung mittels Pulsfeld-Gelelektrophorese (PFGE) von 294 VREf sollte Aufschluss über genetische Verwandtschaften geben. rnEs konnte gezeigt werden, dass VREf in der aquatischen Umwelt weit verbreitet sind. In Bezug auf ihre genetische Diversität zeigten sie ein breites Spektrum an Variabilität. Ebenso konnte im zeitlichen Auftreten von VREf-Typen eine Dynamik beobachtet werden, wodurch sich Veränderungen der Population mit zeitlichem Wechsel ergaben. Enge Verwandtschaften zwischen VREf von Patienten und VREf aus der aquatischen Umwelt konnten nachgewiesen werden. Für zwei VREf gelang der Nachweis des Eintrags in die aquatische Umwelt, von Patienten aus dem Krankenhaus als Eintragsquelle ausgehend, während Zeiten eines Ausbruchs mit nosokomialen Erregern auf den Stationen. rnZusätzlich zur VREf-Population wurden außerdem die Wirkungsweise und Effizienz einer Elektroimpulsanlage untersucht, um ein zukunftsorientiertes Verfahren zur Desinfektion von bakteriell belasteten Abwässern zu entwickeln. Weiterführend wurde getestet, inwiefern sich verschiedene klinisch relevante VREf durch ein gepulstes elektrisches Feld abtöten lassen. rnEs konnte gezeigt werden, dass das synergistische Zusammenwirken des elektrischen Feldes und der Prozesstemperatur die Höhe der Keimzahlreduktion der Enterokokken beeinflussen. Dabei wurde eine isolatabhängige Elektroresistenz der VREf gegenüber gepulsten elektrischen Feldern bewiesen. Die untersuchten VREf ließen sich, im Gegensatz zu einem Vancomycin-sensiblen Stamm, nicht effizient durch die Elektroimpulsanlage abtöten, was den praktischen Einsatz einer solchen Elektroimpulsanlage als wirkungsvolles Desinfektionsverfahren in Frage stellte.