Detection of cytotoxic activity on Vero cells in clinical isolates of Serratia marcescens

Cytotoxin production was studied in 60 Serratia marcescens strains isolated from hospitalized patients. Association of cytotoxic activity with serotype, source of isolation and presence of plasmids was also evaluated. Thirteen of the 60 S. marcescens strains produced a cytotoxic effect of Vero cells. These strains were isolated from distinct clinical sources and classified into seven different serotypes (O1:H7; O4:NM; O10:NT; O19:NM; O6,14:H4; O6,14:NM and O6,14:H1). No relationship was observed between cytotoxic activity and clinical source or serotypes of the strains. Plasmids from five cytotoxin-producing S. marcescens strains were transferred to E. Coli K12/711. The transconjugants did not exhibit cytotoxicity, indicating that the cytotoxic effect is not plasmid-mediated among these strains. Although a cytotoxic activity was demonstrated in filtrates of some S. marcescens strains, further studies should be performed to assess the role of this toxin in pathogenesis.

Nocardia infection in renal transplant recipient: diagnostic and therapeutic considerations

In the present report the authors discuss the diagnostic difficulties, therapeutic measures and the clinical course of Nocardia infection which occurred among renal transplant recipients at the University Hospital of the Faculty of Medicine of Ribeirão Preto, University of São Paulo (UH-FRP), from 1968 to 1991. Among 500 individuals submitted to renal transplant, 9 patients developed Nocardiosis at varying times after transplant (two months to over two years). All the patients had pulmonary involvement and their most common symptoms were fever, cough and pleural pain. Dissemination of the process is common and three patients presented cutaneous abscesses, four CNS involvement and one had pericarditis due to Nocardia. The diagnostic is quite difficult since there is no specific clinical picture, concomitant infections are frequent and the microorganism presents slow growth in culture (ranging from four to forty days, in our experience). In this report, three cases were only diagnosed by necropsy. The treatment of choice is a combination of Sulfamethoxazole and Trimethoprim (SMX-TMP). In the present series, overall mortality was 77 (7 cases) and in five of the patients who died the diagnosis was late. All the patients who had CNS involvement died.

Fagotipagem e resistencia as drogas de amostras de Staphylococcus aureusmultiresistentes no HU/UFPB / Phage typing and drug resistence in multiple-antibiotic-resistant Staphylococcus aureus in a university hospital

Foi realizado um estudo epidemiologico de 38 amostras de Staphylococcus aureus isolados de pacientes internos no Hospital Universitario da UFPb. Em sua aioria, aslinhagens estudadas apresentaram multiresistencia as drogas, das quais 31,6% demonstraram resistencia a oxacilina (ORSA). A partir de testes de sensibilidade as drogas determinou-se o padrao de resistencia das amostras estudadas, com especial atençao as amostras ORSA nas quais foi detectada uma resistencia media de 75,0% a bateria de drogas utilizadas. As amostras foram submetidas a fagotipagem utilizando a RTD e100xRTD obtendo-se 22/38 (57,9%) de amostras tipaveis, sendo a maioria 11/22 (50,0%) caracterizada no grupo fagico III. No entanto,considerando o elevado numero de amostras nao tipaveis, e que coincidiu em grande parte dos casos com cepas de resistencia elevada, concluimos ser necessario a utilizaçao de tecnicas moleculares para melhor estabelecer a analise epidemiologica.

Meningencefalite por Pasteurella multocida: estudo clínico-laboratorial de um caso em lactente / Pasteurella multocida meningencephalitis: clinical and laboratory study of a case in a newborn infant

Os autores apresentam descriçäo clínico-laboratorial e evolutiva do caso de lactente com o diagnóstico de maningencefalite por Pasteurella multocida que apresentou na evoluçäo evoluçäo atraso neuromotor, manifestaçöes epilépticas, surdez neurossensorial e paresia crural a esquerda. Fazem também breve revisäo do papel deste agente etiológico na patologia humana. Ressaltam a importância da P. multocida em casos de meningites bacterianas, fazendo-se o diagnóstico laboratorial diferencial com o Haemophilus influenzae e Neisseria meningitidis em processos infecciosos conseqüentes a arranhadura ou mordida de animais e nas bacteremias ou septicemias em pacientes com hepatopatias crônicas ou em estados de imunodepressäo

Contraimunoeletroforese e hemaglutinacao passiva como metodos complementares para o estudo da infeccao meningococica. / Counterinmmunoelectrophoresis and passive hemagglutination as complementary methods in the study of meningococcal infection

Analisamos 108 casos de meningite bacteriana, atendidos no Hospital das Clinicas da FMRP-USP, atraves de bacterioscopia do sedimento do liquido cefalorraquiano (LCR) corado pelo Gram, cultura do LCR em agar-chocolate, contraimunoeletroforese (CIE) do LCR para pesquisa de polissacarides meningococicos A e C, de hemofilos tipo b e de pneumococo com soro polivalente, hemocultura e hemaglutinacao passiva (HP) para avaliar titulos de anticorpos antimeningococicos A e C no soro. Embora nem todos os testes tenham sido aplicados simultaneamente, foram diagnosticados 71 casos de meningites meningococicas (41 tipo A, 11 C, 2A e C e 18 nao tipadas), 9 por hemofilos tipo b, 6 por pneumococos, 2 por E. aerogenes, 1 por Streptococcus sp e 19 permaneceram sem diagnostico etiologico. Isoladamente, a HP revelou maior indice de positividade, enquanto que os metodos tradicionais (bacterioscopia e cultura do LCR) e a CIE forneceram resultados satisfatorios. A associacao de pelo menos dois desses metodos aumentou significantemente a porcentagem de identificacao dos casos de meningite meningococica