Surto de listeria monocytogenes na Região de Lisboa e Vale do Tejo : 2009-2011

RESUMO - O género Listeria contém oito espécies (L. monocytogenes, L. ivanovii, L. innocua, L. seeligeri, L. welshimeri, L. grayi, L. marthii, e a L. rocoutiae), das quais duas são patogénicas. L. monocytogenes é patogénica para humanos e animais; L. ivanovii primeiramente infecta animais e raramente causa doenças em humanos. A Listeria monocytogenes é uma bactéria patogénica Gram-positiva facultativa intracelular, ubíqua na natureza. Nos últimos anos o número de casos de listeriose tem vindo a aumentar. Pode causar uma doença rara e grave chamada listeriose, especialmente nas mulheres grávidas, nos idosos ou em indivíduos com o sistema imunitário debilitado, de maneira esporádica ou em forma surtos. Realizou-se um estudo observacional, descritivo com o objectivo de se fazer a descrição e a caracterização do surto de listeriose ocorrido na região de Lisboa e Vale do Tejo entre 2009-2011. O período de maior número de casos diagnosticados de listeriose ocorreu entre o mês de Abril e Agosto de 2010. Mas a janela temporal em que ocorreu o surto estendeu-se de Março de 2009 a Janeiro de 2012. Ocorreram 51 casos de internamento com diagnóstico de listeriose, dos quais 25 casos foram confirmados, pela técnica de PFGE, pertencer à mesma estirpe I, sorotipo 4b e pulsotipo 070 e 0101. Na maioria dos casos eram do sexo feminino, com uma média de 57,14 anos de idade e com residência na região de Lisboa e Vale do Tejo. Em 96,08% dos doentes internados com listeriose apresentavam factores de predisposição, comorbilidade e /ou imunossupressão. A bacteriemia foi a manifestação clínica mais frequente, seguida da meningite. A letalidade da listeriose foi de 15,69%.

Spore differentiation in relation to the infectious cycle of the enteric pathogen Clostridium difficile

Clostridium difficile is a gram positive, spore former, anaerobic bacterium that is able to cause infection and disease, with symptoms ranging from mild diarrhea to pseudomembranous colitis, toxic megacolon, sepsis and death. In the last decade new strains have emerged that caused outbreaks of increased disease severity and higher recurrence, morbidity and mortality rates, and C. difficile is now considered both a main nosocomial pathogen associated with antibiotic therapy as well as a major concern in the community.(...)

Factores de riesgo asociados a infecciones por gram positivos vs. gram negativos en neutropenicos febriles

Investigar potenciales factores de riesgo asociados a infecciones por bacterias gram positivas vs. gram negativas en los pacientes con Neutropenia febril postquimioterapia. Diseño: Conducimos un estudio analítico de casos y controles basado en pacientes hospitalizados para identificar los factores de riesgo asociados a infecciones bacterianas entre pacientes con neutropenia febril. Se recolecto la información en un cuestionario diseñado para la investigación. Pacientes: Comparamos 65 casos infectados por gram positivos con 200 controles infectados por gram negativos hospitalizados con diagnostico de Neutropenia febril postquimioterapia. Análisis: Usamos el Odds Ratio como el resumen básico estadístico para calcular variaciones en el riesgo. Principales resultados: El análisis univariado mostro que lesiones en piel ( -OR 7,2; IC 95%: 2,89-17,9, p< 0,001) y uso de catéter central ( -OR 5,8; IC 95%: 2,0-16,8, p < 0,010) fueron asociados a infecciones por gram positivos. Conclusiones: Este estudio mostro que entre pacientes con Neutropenia febril postquimioterapia las lesiones en piel y uso de catéter central están asociados al desarrollo de infección por gram positivos. Palabras claves: Neutropenia febril; factores de riesgo; infecciones bacterianas.

Deteção e Quantificação Precoce de Clostridium perfringens em Frangos de Crescimento Rápido e de Plumagem Branca na Região de Lisboa e Vale do Tejo

Clostridium perfringens é uma bactéria anaeróbia Gram positiva, formadora de esporos e produtora de toxinas capazes de causar um amplo espectro de doenças em humanos e animais. Em frangos de crescimento rápido e de plumagem branca pode causar lesões e manifestações clínicas severas como enterite necrótica aviária (ENA), associada a uma baixa eficiência produtiva e avultadas perdas económicas. Neste estudo pretendeu-se avaliar a utilização de um teste de ensaio imunocromatográfico de fluxo lateral, o Clostridium FirstTestTM, para deteção e quantificação precoce de C. perfringens em frangos de crescimento rápido e plumagem branca e posterior relação entre a presença do agente e as características dos bandos (peso médio à chegada, idade dos bandos à amostragem), fatores ambientais (densidade populacional, temperatura ambiente, humidade da cama) e os indicadores de produção (ganho médio diário, Índice de Conversão Alimentar e percentagem de mortalidade). Para tal, foram analisadas amostras fecais de trinta bandos, em dezoito explorações integradas, na Região de Lisboa e Vale do Tejo. De acordo com a classificação do Clostridium FirstTestTM, dos trinta bandos amostrados entre o décimo primeiro e o décimo quinto dia de vida, 30 % foram classificados como “Positivo” (n=9) e 10 % foram classificados como “Muito Positivo” (n=3); apresentando concentrações médias de C. perfringens de 0,1322 ng/ml e 0,3267 ng/ml, respectivamente. Os restantes bandos, 60% (n=18), foram considerados “Normal” e apresentaram concentrações médias de C. perfringens de 0,0283 ng/ml. As amostras fecais dos bandos classificados de “Positivo” e “Muito Positivo” foram posteriormente sujeitas a análise microbiológica apresentando ambos os grupos unidades formadoras de colónias (UFC), identificadas como C. perfringens. Verificou-se que não existe relação entre os resultados do Clostridium FirstTestTM e as características dos bandos, os fatores ambientais e os indicadores de produção. Verificou-se uma diminuição dos níveis de C. perfringens nos bandos sujeitos a tratamento.

Clostridium bolteae sp. nov., isolated from human sources

Seven obligately anaerobic, gram-positive, rod-shaped, spore-forming organisms isolated from human sources were characterized using phenotypic and molecular taxonomic methods. Comparative 16S rRNA gene sequencing showed that the strains were genetically highly related to each other (displaying >99% sequence similarity) and represent a previously unknown sub-line within the Clostridium coccoides rRNA group of organisms. Strains of the unidentified bacterium used carbohydrate as fermentable substrates, producing acetic acid and lactic acid as the major products of glucose metabolism. The closest described species to the novel bacterium corresponded to Clostridium clostridioforme, although a 16S rRNA sequence divergence of 3% demonstrated they represent different species. Genomic DNA-DNA pairing studies confirmed the separateness of the unknown species and Clostridium clostridioforme. Based on phenotypic and phylogenetic evidence, it is therefore proposed that the unknown bacterium, be classified as Clostridium bolteae sp. nov. The type strain of Clostridium bolteae is WAL 16351(T) (= ATCC(T) = BAA-613(T), CCUG(T) = 46953(T)).

Anaerotruncus colihominis gen. nov., sp. nov., from human faeces

Phenotypic and phylogenetic studies were performed on two isolates of an unidentified Gram-positive, anaerobic, non-spore-forming, rod-shaped bacterium that was isolated from human faeces. The organisms were catalase-negative, produced acetic and butyric acids as end products of metabolism and possessed a DNA G+C content of approximately 54 mol%. Comparative 16S rRNA gene sequencing demonstrated that the two isolates were related closely to each other and formed a hitherto unknown sublineage within the Clostridium leptum rRNA cluster of organisms. Based on phylogenetic and phenotypic evidence, it is proposed that the unknown bacterium should be classified in a novel genus as Anaerotruncus colihominis gen. nov., so. nov. The type strain of Anaerotruncus colihominis is WAL 14565(T) = CCUG 45055(T) = CIP 107754(T).

Slackia faecicanis sp nov., isolated from canine faeces

Morphological, biochemical and molecular genetic studies were carried out on an unknown non-spore-forming, Gram-positive, rod-shaped bacterium that was isolated from dog faeces. The bacterium grew under strictly anaerobic conditions, was asaccharolytic, and possessed a relatively high G + C content of 61 mol%. Phylogenetic analysis based on comparative 16S rRNA gene sequencing showed that the unidentified bacterium was a member of the family Coriobacteriaceae and represents a hitherto unknown subline within the genus Slackia. Based on the presented findings, a novel species, Slackia faecicanis sp. nov., is described. The type strain of Slackia faecicanis is 5WC12(T) (=CCUG 48399(T)=CIP 108281(T)).

Streptococcus castoreus sp nov., isolated from a beaver (Castor fiber)

A previously undescribed, Gram-positive, catalase-negative, Streptococcus-like organism originating from a European beaver (Castor fiber) was subjected to a taxonomic study. The organism displayed beta-haemolytic activity and gave a positive reaction with Lancefield group A antisera. Based on the results of biochemical testing, the organism was tentatively identified as a member of the genus Streptococcus, but it did not correspond phenotypically to any recognized species of this genus. Comparative 16S rRNA gene sequencing studies confirmed this assignment, with the bacterium forming a hitherto unknown subline within the genus. Sequence divergence values of greater than 3% from other reference streptococcal species, however, demonstrated that the unidentified coccus-shaped organism represents a hitherto unknown species. Based on phenotypic and molecular phylogenetic evidence, it is therefore proposed that the unknown organism from a beaver be classified as a novel species, Streptococcus castoreus sp. nov. The type strain is M605815/03/2(T) (=CCUG 48115(T) = CIP 108205(T)).

Jeotgalicoccus pinnipedialis sp nov., from a southern elephant seal (Mirounga leonina)

A previously unknown Gram-positive, catalase-positive, facultatively anaerobic, non-spore-forming, coccus-shaped bacterium (A/G14/99/10(T)), originating from the mouth of a female southern elephant seal, was subjected to a taxonomic analysis. Comparative 16S rRNA gene-sequencing showed that the organism formed a hitherto unknown subline within the catalase-positive, low-G+C, Gram-positive cocci, exhibiting a specific association with species of the genus Jeotgalicoccus. Sequence divergence values of approximately 7%, together with phenotypic differences, showed the unknown bacterium to be distinct from the two described species of this genus, Jeotgalicoccus halotolerans and Jeotgalicoccus psychrophilus. Based on phenotypic and phylogenetic considerations, it is proposed that strain A/G14/99/10(T)=CCUG 42722(T)=CIP 107946(T) from the mouth of a seal be classified as the type strain of a novel species of the genus Jeotgalicoccus, Jeotgalicoccus pinnipedialis sp. nov.

Characterization of some Actinomyces-like isolates from human clinical sources: description of Varibaculum cambriensis gen. nov., sp nov

Fifteen strains of an anaerobic, catalase-negative, gram-positive diphtheroid-shaped bacterium recovered from human sources were characterized by phenotypic and molecular chemical and molecular genetic methods. The unidentified bacterium showed some resemblance to Actinomyces species and related taxa, but biochemical testing, polyacrylamide gel electrophoresis analysis of whole-cell proteins, and amplified 16S ribosomal DNA restriction analysis indicated the strains were distinct from all currently named Actinomyces species and related taxa. Comparative 16S rRNA gene sequencing studies showed that the bacterium represents a hitherto-unknown phylogenetic line that is related to but distinct from Actinomyces, Actinobaculum, Arcanobacterium, and Mobiluncus. We propose, on the basis of phenotypic and phylogenetic evidence, that the unknown bacterium from human clinical specimens should be classified as a new genus and species, Varibaculum cambriensis gen. nov., sp. nov. The type strain of Varibaculum cambriensis sp. nov. is CCUG 44998(T) = CIP 107344(T).

Actinomyces dentalis sp nov., from a human dental abscess

A previously undescribed filamentous, beaded, Gram-positive, rod-shaped bacterium was isolated from pus of a human dental abscess. Based on its cellular morphology end the results of biochemical testing the organism was tentatively identified as a member of the genus Actinomyces, but it did not correspond to any currently recognized species of this genus. Comparative 16S rRNA gene sequencing studies showed the bacterium represents a distinct subline within the genus Actinomyces, clustering within a group of species that includes Actinomyces bovis, the type species of the genus. Sequence divergence values of >8% with other recognized species within this phylogenetic group clearly demonstrated that the organism represents a hitherto unknown species. Based on biochemical and molecular phylogenetic evidence, it is proposed that the unidentified organism recovered from a dental abscess be classified as a novel species, Actinomyces dentalis sp. nov. The type strain is R18165(T) (= CCUG 48064(T) = CIP 108337(T)).

Corynebacterium atypicum sp. nov., from a human clinical source, does not contain corynomycolic acids

An unusual Gram-positive, facultatively anaerobic, catalase-positive, diphtheroid-shaped organism originating from an unknown human clinical source was characterized by biochemical, molecular chemical and molecular phylogenetic methods. Based on its morphological and biochemical characteristics and the presence of a murein based on meso-diaminopimelic acid, the unidentified organism was tentatively assigned to the genus Corynebacterium. However, the unknown organism was found to lack the distinctive, short-chain corynomycolic acids that are considered to be characteristic of this genus. Despite the absence of these characteristic lipids, comparative 16S rRNA gene sequencing showed that the unknown bacterium was phylogenetically a member of the genus Corynebacterium and was distinct from all currently known species. Based on both phenotypic and 16S rRNA sequence considerations, it is proposed that the unknown organism be classified as a novel species, Corynebacterium atypicum sp. nov. The type strain of C. atypicum is strain R2070(T) (= CCUG 45804(T) = CIP 107431(T)).

Anaerofustis stercorihominis gen. nov., sp nov., from human faeces

Phenotypic and phylogenetic studies were performed on an unidentified Gram-positive, strictly anaerobic, non-spore-forming, rod-shaped bacterium isolated from human feces. The organism was catalase-negative, resistant to 20% bile, produced acetic and butyric acids as end products of glucose metabolism, and possessed a G + C content of approximately 70 mol %. Comparative 16S rRNA gene sequencing demonstrated that the unidentified bacterium was a member of the Clostridium sub-phylum of the Gram-positive bacteria, and formed a loose association with rRNA cluster XV. Sequence divergence values of 12% or greater were observed between the unidentified bacterium and all other recognized species within this and related rRNA clusters. Treeing analysis showed the unknown anaerobe formed a deep line branching near to the base of rRNA cluster XV and phylogenetically represents a hitherto unknown taxon, distinct from Acetobacterium, Eubacterium sensu stricto, Pseudoramibacter and other related organisms. Based on both phylogenetic and phenotypic evidence, it is proposed that the unknown bacterium from feces be classified in a new genus Anaerofustis, as Anaerofustis stercorihominis sp. nov. The type strain of Anaerofustis stercorihominis is ATCC BAA-858(T) = CCUG 47767(T). (C) 2003 Elsevier Ltd. All rights reserved.

Streptococcus equi subsp ruminatorum subsp nov., isolated from mastitis in small ruminants

Six isolates of an unknown Gram-positive, catalase-negative, chain-forming, coccus-shaped organism isolated from ovine and caprine mastitis were characterized by phenotypic and molecular taxonomic methods. On the basis of cellular morphology and the results of biochemical tests, the organism was tentatively identified as a streptococcal species. Comparative 16S rRNA gene sequencing studies confirmed that the organism is a member of the genus Streptococcus, with Streptococcus equi as its closest phylogenetic relative (98(.)8% similarity). DNA-DNA pairing studies showed that the unidentified organism displayed more than 70% relatedness to the type strains of S. equi subsp. equi and subsp. zooepidemicus. Despite the relatively high DNA-DNA reassociation values, biotyping and ribotyping allowed clear differentiation of the unknown bacterium from the two recognized subspecies of S. equi. On the basis of phenotypic and molecular genetic evidence, it is proposed that the unknown Streptococcus isolates from ovine and caprine mastitis be classified as a novel subspecies, Streptococcus equi subsp. ruminatorum subsp. nov. The type strain is CECT 5772(T) (=CCUG 47520(T) = Mt 167(T)).

Atopostipes suicloacale gen. nov., sp. nov., isolated from an underground swine manure storage pit

Phenotypic and molecular genetic studies were performed on an unknown facultative anaerobic, catalase-negative, non-spore-forming, rod-shaped bacterium isolated from a pig manure storage pit. The unknown bacterium was nutritionally fastidious with growth enhanced by the addition of rumen fluid and was phenotypically initially identified as an Eubacterium species. Comparative 16S rRNA gene sequencing studies, however, revealed that the unknown bacterium was phylogenetically distant from Eubacterium limosum (the type species of the genus Eubacterium) and related organisms. Phylogenetically, the unknown species displayed a close association with an uncultured organism from human subgingival plaque and formed an unknown sub-line within a cluster of organisms which includes Alloioccoccus otitis, Alkalibacterium olivoapovliticus, Allofustis seminis, Dolosigranulum pigrum, and related organisms, within the low mol% G + C Gram-positive bacteria. Sequence divergence values of > 8% with all known taxonomically recognised taxa, however, clearly indicates the novel bacterium represents a hitherto unknown genus. Based on both phenotypic and phylogenetic considerations, it is proposed that the unknown bacterium from pig manure be classified in a new genus and species, as Atopostipes suicloacale gen. nov., sp. nov. The type strain of Atopostipes suicloacale is PPC79(T) = NRRL 23919(T) = DSM 15692(T). Crown Copyright (C) 2004 Published by Elsevier Ltd. All rights reserved.