Similaridade genética pelo RAPD-PCR de cepas de Staphylococcus sp isolados de portadores humanos e de camas de uma unidade hospitalar

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Investigação de genes de resistência a carbapenêmicos e aminoglicosídeos e tipagem molecular de amostras de Acinetobacter baumannii isoladas de pacientes internados em unidades de terapia intensiva de um hospital terciário

Pós-graduação em Microbiologia - IBILCE

Investigação de genes de resistência às quinolonas e aminoglicosídeos em Klebsiella pneumoniae produtoras de carbapenemases do tipo KPC em hospitais do estado de São Paulo

Pós-graduação em Microbiologia - IBILCE

Síntese de N-Alquilsulfonamidas análogas do PABA com potencial atividade antagonista de canais iônicos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Piperacillin/tazobactam-induced neurotoxicity in a hemodialysis patient: a case report

Antibiotics are potentially a cause of neurotoxicity in dialysis patients, the most common are thebeta-lactams as ceftazidime and cefepime, and few cases have been reported after piperacillin/tazobactam use. This report presents a case of a hypertensive and diabetic 67-year-old woman inregular hemodialysis, which previously had a stroke. She was hospitalized presenting pneumonia,which was initially treated with cefepime. Two days after treatment, she presented dysarthria, lefthemiparesis, ataxia, and IX and X cranial nerves paresis. Computed tomography showed no acutelesions and cefepime neurotoxicity was hypothesized, and the antibiotic was replaced bypiperacillin/tazobactam. The neurologic signs disappeared; however, 4 days after with piperacillin/tazobactam treatment, the neurological manifestations returned. A new computed tomographyshowed no new lesions, and the second antibiotic regimen withdrawn. After two hemodialysissessions, the patient completely recovered from neurological manifestations. The patient presentedsequentially neurotoxicity caused by two beta-lactams antibiotics. This report meant to alertclinicians that these antibiotics have dangerous neurological effects in chronic kidney diseasepatients.

Metabolic engineering of beta-oxidation in Penicillium chrysogenum for improved semi-synthetic cephalosporin biosynthesis

Industrial production of semi-synthetic cephalosporins by Penicillium chrysogenum requires supplementation of the growth media with the side-chain precursor adipic acid. In glucose-limited chemostat cultures of P. chrysogenum, up to 88% of the consumed adipic acid was not recovered in cephalosporinrelated products, but used as an additional carbon and energy source for growth. This low efficiency of side-chain precursor incorporation provides an economic incentive for studying and engineering the metabolism of adipic acid in P. cluysogenum. Chemostat-based transcriptome analysis in the presence and absence of adipic acid confirmed that adipic acid metabolism in this fungus occurs via beta-oxidation. A set of 52 adipate-responsive genes included six putative genes for acyl-CoA oxidases and dehydrogenases, enzymes responsible for the first step of beta-oxidation. Subcellular localization of the differentially expressed acyl-CoA oxidases and dehydrogenases revealed that the oxidases were exclusively targeted to peroxisomes, while the dehydrogenases were found either in peroxisomes or in mitochondria. Deletion of the genes encoding the peroxisomal acyl-CoA oxidase Pc20g01800 and the mitochondrial acyl-CoA dehydrogenase Pc20g07920 resulted in a 1.6- and 3.7-fold increase in the production of the semi-synthetic cephalosporin intermediate adipoyl-6-APA, respectively. The deletion strains also showed reduced adipate consumption compared to the reference strain, indicating that engineering of the first step of beta-oxidation successfully redirected a larger fraction of adipic acid towards cephalosporin biosynthesis. (C) 2012 Elsevier Inc. All rights reserved.

Progettazione e sintesi di nuovi derivati azetidinonici biologicamente attivi

In this PhD-thesis new synthetic approaches towards new azetidinone derivatives are described. In particular, 4-alkyliden-β-lactams were used as starting materials for the preparation of new biologically active compounds. The carbapenem Thienamycin has got a broad spectrum of activity as antibiotic. It has got 3 stereocenters and apart of one epimer, all isomers have been synthesized. Using the 4-alkyliden-β-lactam benzilyc ester as precursor, we developed a synthesis for this missing epimer, which is described in chapter II. Biological tests in order to establish its biological activity are under way. The Hunsdiecker-Borodine reaction was extensively studied for the preparation of the mono halogenated and – surprisingly – the dihalogenated derivative from the 4-alkyliden-azetidinone carboxylic acid. The herein described synthetic procedures allowed the preparation of chloro-, bromo- and iodo derivatives in good to excellent yield. Furthermore, the reaction mechanism was investigated by NMR-experiments and is described in detail in chapter III. In chapter IV, synthetic approaches towards new β-lactam derivatives for inhibition of the histone deacetylase enzymes (HDACs) are reported. In collaboration with the company Sigma-Tau (Rome), 14 new β-lactams were synthesized. The new β-lactams were evaluated for the activity showing a promising activityparticulary, 10 of the β-lactams synthesized were evaluated for the in vitro inhibitory activity against the 11 human HDACs isoforms and they showed a selective inhibition of HDAC6 or HDAC8 in micromolar range. Finally, preliminary studies were conducted for the employment of 4-alkyliden-β-lactams as precursors for the synthesis of chiral β-amino acids by an opening of the β-lactam ring. In chapter V is described the ring opening reaction catalyzed by the enzyme lipase Cal-B. Preliminary results have shown that the enzyme not only catalyzes the ring opening of the β-lactam precursor, moreover, it leads to the formation of a cyclic dimer by the reaction of two molecules of β-amino acid obtained.

Sintesi di molecole biologicamente attive con tecniche chemoenzimatiche:beta-lattami, profeni e alfa-amminoacidi non naturali

Il progetto di ricerca di questa tesi è stato focalizzato sulla sintesi di tre classi di molecole: β-lattami, Profeni e α-amminonitrili, utilizzando moderne tecniche di sintesi organica, metodologie ecosostenibili e strategie biocatalitiche. I profeni sono una categoria di antiinfiammatori molto diffusa e in particolare abbiamo sviluppato e ottimizzato una procedura in due step per ottenere (S)-Profeni da 2-arilpropanali raceme. Il primo step consiste in una bioriduzione delle aldeidi per dare i relativi (S)-2-Aril Propanoli tramite un processo DKR mediato dall’enzima Horse Liver Alcohol Dehydrogenase. Il secondo, l’ossidazione a (S)-Profeni, è promossa da NaClO2 e TEMPO come catalizzatore. Con lo scopo di migliorare il processo, in collaborazione con il gruppo di ricerca di Francesca Paradisi all’University College Dublino abbiamo immobilizzato l’enzima HLADH, ottenendo buone rese e una migliore enantioselettività. Abbiamo inoltre proposto un interessante approccio enzimatico per l’ossidazione degli (S)-2-Aril Propanoli utilizzando una laccasi da Trametes Versicolor. L’anello β-lattamico è un eterociclo molto importante, noto per essere un interessante farmacoforo. Abbiamo sintetizzato nuovi N-metiltio beta-lattami, che hanno mostrato un’attività antibatterica molto interessante contro ceppi resistenti di Staphilococcus Aureus prelevati da pazienti affetti da fibrosis cistica. Abbiamo poi coniugato gruppi polifenolici a questi nuovi β-lattami ottenendo molecule antiossidanti e antibatteriche, cioè con attività duale. Abbiamo poi sintetizzato un nuovo ibrido retinoide-betalattame che ha indotto differenziazione si cellule di neuroblastoma. Abbiamo poi sfruttato la reazione di aperture dell’anello monobattamico tramite enzimi idrolitici, con lo scopo di ottenere β-amminoacidi chirali desimmetrizzati come il monoestere dell’acido β–amminoglutammico. Per quando riguarda gli α-amminonitrili, è stato sviluppato un protocollo di Strecker. Le reazioni sono state molto efficienti utilizzando come fonte di cianuro l’acetone cianidrina in acqua, utilizzando differenti aldeidi e chetoni, ammine primarie e secondarie. Per mettere a punto una versione asimmetrica del protocollo, abbiamo usato ammine chirali con lo scopo di ottenere nuovi α-amminonitrili chirali.

Aufbau von 2-alkinyl-substituierten Azepanen und Piperidinen und deren Aza-Claisen-Umlagerungen zu Allenyllactamen

Definiert konfigurierte mittelgroße ungesättigte Heterocyclen sind wertvolle Zwischenstufen in der Naturstoff- und Wirkstoffsynthese. Es konnte gezeigt werden, dass 2-alkinyl-substituierte Piperidine und Azepane in einer Aza-Keten-Claisen-Reaktion zu 10- und 11-gliedrigen Allenyllactamen umgelagert werden können. Ein 9-gliedriges Allenyllactam konnte nicht dargestellt werden (Ringspannung). Über eine sechs- bis sieben-stufige Reaktionssequenz konnten optisch aktive, geschützte Piperidinole aufgebaut werden. Es wurden Auxiliar kontrollierte Hetero-Diels-Alder-Reaktionen, diastereoselektive Reduktionen, Bestmann-Ohira Umlagerungen zu Alkinen und verschiedene Alkin-Funktionalisierungen erarbeitet. Eine Aza-Claisen-Umlagerung liefert schließlich optisch aktive Lactame deren absolute Konfiguration des Allensystems mittels NOE-NMR-Spektroskopie untersucht werden kann. Limitierungen und Möglichkeiten der Synthese werden eingehend diskutiert. Sowohl der stereochemische Verlauf der Reaktion als auch die Konformation der Produkte ermöglichen eine Fokussierung auf nachfolgende Naturstoffsynthesen vorzunehmen.

Synthese von optisch aktiven 2-Vinyl-piperidinen - Schlüsselbausteine für die Clavepictin-Totalsynthese

Im Rahmen der vorliegenden Arbeit wurden eine Vielzahl optisch aktiver 1,2,6-trisubstituierte Piperidine stereoselekiv dargestellt. Bei der anschließenden Aza-Claisen-Umlagerunge wurden daraus chirale Azecinone (zyklische, ungesättigte, zehngliedrige Lactame) gebildet, die sich für die Totalsynthese u. a. von Clavepictin A eignen.rnrnDazu wurde zunächst über eine weitere zwitterionische Aza-Claisen-Umlagerung ein Dien aufgebaut, welches durch intramolekulare Grubbs-Metathese zum Piperidin geschlossen werden konnte. Daraus wurde ein Baikiain- sowie ein Pipecolinsäure-Derivat hergestellt.rnrnAuf einem weiteren Weg zu hochsubstituierten Piperidinen wurde eine von Katritzky et al. erarbeitete Synthese eines Bisaminals auf ihre Flexibilität bezüglich des Substitutionsmusters in 2- und 6-Position am Piperidinring durch eine Kaskade an Reduktionen und Grignard-Reaktionen zu stereoselektiv trisubstituierten 2-Vinyl-Piperidinen untersucht. rnrnDie anschließende zwitterionische Aza-Claisen-Umlagerung an diesen Vinyl-Piperidinen mit verschiedenen Säurefluoriden diente jeweils zur Überprüfung der Tauglichkeit der ausgewählten Reaktionswege zur Totalsynthese von Clavepictin. Durch Strukturbestimmung der gebildeten Azecinone mittels NOESY wurde der erwartete Chiralitätstransfer bei der Umlagerungsreaktion untersucht bzw. bestätigt.rnrnNebenbei wurde dabei ein Chinolizidin-Derivat gefunden, dessen Darstellung durch eine neuartige Dominoreaktion erklärt wurde und dessen Grundstruktur einen weiteren und ggf. kürzeren Syntheseweg zu Clavepictin A und seinen Derivaten zulassen sollte. rn

Diglycosylierte Heterocyclen als potentielle Selektinliganden

In der vorliegenden Arbeit sollten diglycosylierte Heterozyklen als Grundbausteine zur Darstellung eines Mimetikums des Tetrasaccharids Sialyl LewisX verwendet werden. Dabei standen die pharmakokinetische Stabilität sowie der möglichst einfache Zugang zu den Strukturen im Vordergrund. Außerdem sollte die nachträgliche Anbindung an eine ESL-1 Partialsequenz zum Aufbau von Glycopeptiden und deren Verknüpfung zu dendrimeren Strukturen möglich sein. rnIn einem ersten Ansatz sollten C,N-diglycosylierte Isoindolone bzw. Isochinolone aufgebaut werden. Es konnte anhand mehrerer Beispiele gezeigt werden, dass die elektrophile Cyclisierung von o-Alkinylbenzamiden mit Iod nicht die wie in der Literatur beschriebenen Lactame liefert, sondern ein Angriff des Carbonylsauerstoffs zu den entsprechenden Isobenzofuran-1(3H)-iminen bzw. 1H-Isochromen-1-iminen führt. Die Lactame können jedoch durch Reaktion der o-Alkinylbenzamide mit Tetrabutylammoniumfluorid erhalten werden.rnDie zweite Route führte durch 1,3-dipolare Cycloaddition zu 1,4 disubstituierten 1,2,3-Triazolen. Hier gelang der Aufbau eines vollständig deblockierten, mit einem Azid funktionalisierten Trisaccharid Analogons, welches durch enzymatische Sialylierung zum Sialyl LewisX Mimetikum verlängert wurde. Diese Struktur konnte in einer weiteren 1,3-dipolaren Cycloaddition mit einer ebenfalls synthetisierten, leicht abgewandelten Partialsequenz des ESL-1 zu einem Glycokonjugat umgesetzt werden. Des Weiteren gelang der Aufbau zweier teilweise deblockierter Tetrasaccharid Mimetika, wiederum durch enzymatische Elongation.rnAußerdem wurden Versuche unternommen di C-Glycoside durch samariumvermittelte Kupplung zu synthetisieren.rn

Synthesis of new bioactive β-lactam compounds

New biologically active β-lactams were designed and synthesized, developing novel antibiotics and enzymatic inhibitors directed toward specific targets. Within a work directed to the synthesis of mimetics for RGD (Arg-Gly-Asp) sequence able to interact with αvβ3 and α5β1-type integrins, new activators were developed and their Structure-Activity Relationships (SAR) analysis deepened, enhancing their activity range towards the α4β1 isoform. Moreover, to synthesize novel compounds active both against bacterial infections and pulmonary conditions of cystic fibrosis patients, new β-lactam candidates were studied. Among the abundant library of β-lactams prepared, mainly with antioxidant and antibacterial double activities, it was identified a single lead to be pharmacologically tested in vivo. Its synthesis was optimized up to the gram-scale, and pretreatment method and HPLC-MS/MS analytical protocol for sub-nanomolar quantifications were developed. Furthermore, replacement of acetoxy group in 4-acetoxy-azetidinone derivatives was studied with different nucleophiles and in aqueous media. A phosphate group was introduced and the reactivity exploited using different hydroxyapatites, obtaining biomaterials with multiple biological activities. Following the same kind of reactivity, a small series of molecules with a β-lactam and retinoic hybrid structure was synthesized as epigenetic regulators. Interacting with HDACs, two compounds were respectively identified as an inhibitor of cell proliferation and a differentiating agent on steam cells. Additionally, in collaboration with Professor L. De Cola at ISIS, University of Strasbourg, some new photochemically active β-lactam Pt (II) complexes were designed and synthesized to be used as bioprobes or theranostics. Finally, it was set up and optimized the preparation of new chiral proline-derived α-aminonitriles through an enantioselective Strecker reaction, and it was developed a chemo-enzymatic oxidative method for converting alcohols to aldehydes or acid in a selective manner, and amines to relative aldehydes, amides or imines. Moreover, enzymes and other green chemistry methodologies were used to prepare Active Pharmaceutical Ingredients (APIs).

Carbapenems: past, present, and future

In this review, we summarize the current "state of the art" of carbapenem antibiotics and their role in our antimicrobial armamentarium. Among the β-lactams currently available, carbapenems are unique because they are relatively resistant to hydrolysis by most β-lactamases, in some cases act as "slow substrates" or inhibitors of β-lactamases, and still target penicillin binding proteins. This "value-added feature" of inhibiting β-lactamases serves as a major rationale for expansion of this class of β-lactams. We describe the initial discovery and development of the carbapenem family of β-lactams. Of the early carbapenems evaluated, thienamycin demonstrated the greatest antimicrobial activity and became the parent compound for all subsequent carbapenems. To date, more than 80 compounds with mostly improved antimicrobial properties, compared to those of thienamycin, are described in the literature. We also highlight important features of the carbapenems that are presently in clinical use: imipenem-cilastatin, meropenem, ertapenem, doripenem, panipenem-betamipron, and biapenem. In closing, we emphasize some major challenges and urge the medicinal chemist to continue development of these versatile and potent compounds, as they have served us well for more than 3 decades.

Active surveillance of antibiotic resistance prevalence in urinary tract and skin infections in the outpatient setting

The aim of the study was to evaluate the need for active surveillance of antibiotic resistance in ambulatory infections. We measured the prevalence of antibiotic resistance in urinary tract infections (UTIs) (n = 1018) and skin infections (n = 213) diagnosed in outpatients between September 2008 and February 2009 in the Canton of Bern, Switzerland. Samples were stratified into 'solicited' (diagnostic work-up for study purpose only) and 'routine' (diagnostic work-up as part of standard care). Susceptibility patterns were compared for 463 Escherichia coli isolates from UTIs (231 solicited; 232 routine) and 87 Staphylococcus aureus isolates from skin infections (35 solicited; 52 routine). Overall, E. coli showed higher susceptibility to ampicillin, amoxicillin-clavulanic acid and norfloxacin in solicited than in routine samples. Among 15-45-year-old patients, susceptibility rates were comparable between solicited and routine samples for all antibiotics except for amoxicillin-clavulanic acid. However, among patients >45 years old, isolates from routine samples showed lower susceptibility to all β-lactams tested and quinolones than those from solicited samples. Extended-spectrum β-lactamase (ESBL)-producing E. coli isolates were rare (solicited, 0.4%; routine, 1.7%; p 0.4). Susceptibility patterns of S. aureus were comparable between solicited and routine samples. Therefore, in the outpatient setting, susceptibility rates for E. coli isolates differ by indication for urinary culture and age. Surveillance based on samples taken during standard care may underestimate susceptibility rates for uncomplicated infections, especially among the elderly. Reports of resistance data should include age stratification.

The increase of methicillin-resistant Staphylococcus aureus (MRSA) and the presence of an unusual sequence type ST49 in slaughter pigs in Switzerland

Background: In years past, methicillin-resistant S. aureus (MRSA) has been frequently detected in pigs in Europe, North America and Asia. Recent, yet sporadic studies have revealed a low occurrence of MRSA in Switzerland. In 2009, a monitoring survey of the prevalence and genetic diversity of methicillin-resistant S. aureus (MRSA) in slaughter pigs in Switzerland was conducted using methods recommended by the EU guidelines, and using a sampling strategy evenly distributed throughout the year and representative of the Swiss slaughter pig population. Monitoring should determine if the overall prevalence of MRSA in the entire country is increasing over the years and if specific multi-resistant MRSA clones are spreading over the country.;Results: In 2009, the nasal cavities of eight out of 405 randomly selected pigs were positive for MRSA, representing a prevalence of 2.0% (95% CI 0.9-3.9). The following year, 23 out of 392 pigs were positive for MRSA [5.9% prevalence (95% CI 3.8-8.7)]. Three multilocus sequence types (ST), four spa types and two types of staphylococcal cassette chromosome mec (SCCmec) elements were detected. The most frequent genotypes were ST398 (MLST)-(spa)t034-V (SCCmec) (n = 18) and ST49-t208-V (n = 7), followed by ST398-t011-V (n = 4), ST398-t1451-V (n = 1), and ST1-t2279-IVc (n = 1). The isolates displayed resistance to beta-lactams [mecA, (31/31); blaZ, (19/31)]; tetracycline [tet(M), (31/31); tet(K), (30/31)] (n = 31); macrolides and lincosamides [erm(C) (4/31) or erm(A) (18/31)] (n = 22); tiamulin [vga(A)v (9/31) or unknown mechanism (18/31)] (n = 27); trimethoprim [dfr(G) (18/31); spectinomycin [ant(9)-Ia (19/31) or unknown mechanism (3/31)] (n = 22); streptomycin [str(19/31)]; sulphamethoxazole (7/31) and ciprofloxacin (n = 1) (mechanisms not determined).;Conclusions: This study is the first to describe the presence of MRSA ST49 in slaughter pigs, and to demonstrate a significant and nearly three-fold increase of MRSA prevalence in pigs within two years. The presence of a specific clonal lineage of MRSA from Switzerland suggests that it has been selected in Swiss pig husbandry. Effective hygiene measures should be enhanced within the entire pig production chain to suppress the spread of these pathogens into the community.