Chromoblastomycosis in the amazon region, BRazil, caused by fonsecaea pedrosoi, fonsecaea nubica, and Rhinocladiella similis: clinicopathology, susceptibility, and molecular identification

Chromoblastomycosis is a chronic subcutaneous disease caused by human contact with melanized fungioccurring mainly in tropical and subtropical zones worldwide. This study assessed 12 patients with chro-moblastomycosis from Rondˆonia, Brazil, Amazon region. In sum, 83.3% were men, 41.6% were from MonteNegro city, median age was 52.9 years, and median time to disease progression was 12.2 years. Lesions werelocated on the lower limbs (75%), and verruciform was prevalent form (66.6%). After 3 years of treatmentwith itraconazole, two patients were considered cured. The etiological agents were identified by the molec-ular sequence of the ribosomal internal transcribed spacer ITS1, 5.8S, and ITS2 region andß-tubulin genes.Eight strains were identified asFonsecaea pedrosoi, two wereF. nubica,and two wereRhinocladiella similis.The antifungal activity of five drugs was evaluated, and the most active drug was terbinafine (range minimalinhibitory concentration [MIC] 0.015­0.12µg/ml), itraconazole (range MIC 0.03­0.5µg/ml) and voriconazole(range MIC 0.06­0.5µg/ml). The highest MIC was 5-fluorocytosine (range MIC 2­32µg/ml), and ampho-tericin B (range MIC 0.25­2µg/ml). In conclusion, the present study expanded the epidemiological diseasedatabase and described for the first timeF. nubicaandR. similisas chromoblastomycosis agents in theBrazilian Amazon region. Our results confirmed the importance of using molecular methods to identify themelanized fungi and stimulate the recognition of the disease in other places where no cases have beenreported.

Caracterização molecular e fenotípica de amostras bacterianas pertencentes ao complexo Acinetobacter calcoaceticus-Acinetobacter baumannii / Molecular and phenotypic characterization of Acinetobacter calcoaceticus-Acinetobacter baumannii isolates

Nos últimos 30 anos, Acinetobacter tornou-se um dos patógenos de maior preocupação clínica pela falta de terapias eficazes em virtude do fenótipo de multirresistência frequentemente apresentado. Dentre as espécies do gênero Acinetobacter, A. baumannii, A. genoespécie 3 e A. genoespécie 13TU são as mais comumente encontradas a partir de amostras biológicas. Estas espécies ao lado de A. calcoaceticus constituem o complexo A. calcoaceticus-A. baumannii (ACB). Este estudo propõe um esquema composto de duas PCRs para a identificação das espécies de interesse médico que fazem parte do complexo ACB. O método é simples, rápido e, além de identificar as espécies, permite pesquisar a presença de genes de resistência. Foram identificadas 515 amostras do complexo ACB, isoladas de pacientes no período de janeiro de 2005 a dezembro de 2010. A identificação das espécies do complexo ACB foi realizada por esquema composto de duas reações de PCR. Foram avaliados os perfis de sensibilidade por disco difusão e a pesquisa da presença dos genes blaOXA-23-like, blaOXA-24-like, blaOXA-51-like, blaOXA-58-like, blaIMP, blaVIM, blaSIM, blaSPM e blaGIM foi realizada por PCR utilizando-se iniciadores específicos. No grupo de amostras estudas, 82,5% são A. baumannii (425), 11,5% A. genoespécie 13TU (59) e 6,0% A. genoespécie 3 (30), sendo A. baumannii mais isolado em pacientes internados em UTIs (p=0,0407) e A. genoespécie 13TU mais isolado em pacientes de outros ambientes hospitalares (p=0,0204). A. baumannii apresentou menor sensibilidade a todos os antimicrobianos quando comparado com A. genoespécie 13TU e A. genoespécie. 3 (p<0,05). Foi possível observar ao longo do período estudado o aumento significativo da resistência aos carbapenêmicos e da sensibilidade a gentamicina por A. baumannii entre os isolados de pacientes de UTIs (p<0.05). Nenhum dos genes codificadores para metalo-lactamases foi detectado nas amostras estudadas Dentre os cepas resistentes aos carbapenêmico...

The genus Acinetobacter has emerged as one of the most troublesome pathogens for health care institutions globally. Its clinical significance, especially over the last 15 years, has been driven by its remarkable ability to up regulate or acquire resistance determinants, making it one of the organisms threatening the current antibiotic era. A. baumannii, A. 3 and A. 13TU are the most commonly species found from biological samples. These species beside A. calcoaceticus are very closely related and difficult to distinguish from each other by phenotypic properties. Therefore, it has been proposed to refer to these species as the A.calcoaceticus-A. baumannii complex(ACB). In the period from 2005 to 2009, the most frequent bacterial isolates among the nosocomial infection at the HU-USP was ACB (18%). Due to the frequency with which species are involved in ACB outbreaks of infection in the HU-USP and the emergency clinic because of expression of the phenotype of resistance to several classes of antibiotics, this study aimed to identify and characterize the species of complex ACB by molecular methods, to study their mechanisms of resistance and to characterize the different clones from patients admitted to different hospital areas. Furthermore, the ability to characterize biofilm formation, adhesion to different cell lines as well as the mechanisms of cell-cell communication were analyzed. From the ACB complex, 515 samples were identified, isolated from patients from January 2005 to December 2010. The identification of clinical species of the ACB was performed by molecular methods that were developed and validated for identification of Acinetobacter sp. include two reactions of PCR. The profiles of sensibility were evaluated by disc diffusion and the detection of the presence of genes blaOXA-23-like, blaOXA-24-like, blaOXA-51-like, blaOXA-58-like, blaIMP, blaVIM, blaSIM, blaGIM, and blaSPM were performed using specific primers. Molecular typing was performed using...