Infection of expanded polytetrafluoroethylene and Dacron-coated stents with Staphylococcus epidermidis: an experimental study in pigs / Infecção de stents revestidos com politetrafluoretileno expandido e Dacron com Staphylococcus epidermidis: estudo experimental em porcos

Abstract Background Diagnosis of the etiologic agent of endoprosthesis infections is essential to enable treatment, since these infections constitute important complications of endovascular procedures. Sonication of explanted tissue and materials is a technique that can be used to facilitate detection of biofilm-producing bacteria. Objectives To evaluate infection of pigs' aortas after implantation of nitinol stents coated with polytetrafluoroethylene (ePTFE) or Dacron, previously infected with biofilm-producing Staphylococcus epidermidis. Intimal thickening and the inflammatory response in the aortic wall were also evaluated. Methods 11 ePTFE-coated nitinol stents and 10 Dacron stents infected with S. epidermidis strains were implanted in the infrarenal aorta of 21 8-week-old pigs. After 2 weeks, the aorta containing the stents was removed. A vortex mixer and ultrasound were used to homogenize the samples and remove the biofilm. Subsequently, the number of colony-forming units was counted. Results There were no significant differences between the two groups in terms of the number of colony-forming units or of inflammation in the arterial wall. With the exception of one specimen from the Dacron group, all aortic stent cultures were positive for S. epidermidis. Conclusions There were no significant differences in the inflammatory response or infection rate between ePTFE and Dacron-coated stents actively infected with biofilm-producing S. epidermidis. Intimal thickening and the inflammatory response to infection of endoprostheses were similar. These results suggest that the two most widely used stent lining materials have a similar infection rate.

Resumo Contexto O diagnóstico do agente etiológico é essencial para o tratamento das infecções de endoprótese, pois representam uma importante complicação do tratamento endovascular. A sonificação dos tecidos pode ser uma técnica usada para auxiliar na detecção de bactérias produtoras de biofilme. Objetivos Avaliar a infecção da aorta dos porcos após o implante de stents de nitinol revestidos com politetrafluoretileno (ePTFE) ou Dacron, infectados com Staphylococcus epidermidis, produtor de biofilme. O espessamento intimal e a resposta inflamatória na parede aórtica também foram avaliados. Métodos Onze stents de nitinol revestidos com ePTFE e 10 stents de Dacron infectados com cepas de S. epidermidis foram implantados na aorta infrarrenal de 21 porcos com 8 semanas de idade. Após duas semanas, a aorta contendo os stents foi removida. Um misturador de vórtice e ultrassom foram utilizados para homogeneizar as amostras e remover o biofilme. Posteriormente, o número de unidades formadoras de colônias foi contado. Resultados Não houve diferenças significativas no número de unidades formadoras de colônias ou inflamação na parede arterial entre os dois grupos. Todas as culturas de stent aórtico foram positivas para S. epidermidis, exceto uma no grupo Dacron. Conclusões Não houve diferenças significativas na resposta inflamatória ou na taxa de infecção entre os stents revestidos de ePTFE e Dacron, infectados ativamente pelo S. epidermidis produtor de biofilme. O espessamento intimal e a resposta inflamatória à infecção das endopróteses foram semelhantes. Esses resultados sugerem que os dois materiais de revestimento de stent mais amplamente utilizados têm uma taxa de infecção semelhante.

Group B Streptococcus detection in pregnant women via culture and PCR methods

Abstract INTRODUCTION: Group B Streptococcus (GBS), a source of neonatal infection, colonizes the gastrointestinal and genitourinary tracts of pregnant women. Routine screening for maternal GBS in late pregnancy and consequent intrapartum antibiotic prophylaxis have reduced the incidence of early-onset GBS neonatal infection. The aim of this study was to evaluate the performance of PCR, compared to culture (gold standard), in GBS colonization screening of pregnant women, and to establish the prevalence of GBS colonization among this population. METHODS: Vaginal introitus and perianal samples were collected from 204 pregnant women, between the 35th and 37th weeks of pregnancy, at the Obstetrics and Gynecology Unit of the University of Caxias do Sul General Hospital between June 2008 and September 2009. All samples were cultured after enrichment in a selective medium and then assayed by culture and PCR methods. RESULTS: The culture and PCR methods yielded detection rates of vaginal/perianal GBS colonization of 22.5% and 26%, respectively (sensitivity 100%; specificity 95.6%; positive and negative predictive values 86.8% and 100%, respectively). A higher prevalence of GBS colonization was detected in the combined vaginal and perianal samples by both culture and PCR assay analyses. CONCLUSIONS: PCR is a faster and more efficient method for GBS screening, allowing for optimal identification of women who should receive intrapartum antibiotic prophylaxis to prevent newborn infection.

Performance of a molecular assay to detect Mycobacterium tuberculosis complex DNA in clinical specimens: multicenter study in Brazil

BACKGROUND In high tuberculosis (TB) burden countries, there are few data on the performance of new molecular commercialised assays developed locally. OBJECTIVE To evaluate the performance of a new molecular commercialised assay for TB diagnosis (Detect-TB) in three laboratories. METHODS A total of 302 sputum samples from an equal number of patients with presumptive diagnosis of pulmonary tuberculosis (PTB) were submitted for routine smear microscopy, culture, and Detect-TB assay at three different sites in Brazil (the cities of Caxias do Sul, São Paulo and Canoas). FINDINGS Seventy four (24.7%) TB cases were diagnosed (65 bacteriologically confirmed). When compared to smear microscopy/culture results, the overall sensitivity and specificity of Detect-TB assay was 84.6% (CI 95%; 73.7-91.6) and 93.1% (CI 95%; 89.1-95.8), respectively. When compared to bacteriological and clinical diagnostic criteria, the sensitivity and specificity of Detect-TB assay was 74.3% (CI 95%; 63.3-82.9) and 92.9% (CI 95%; 88.7-95.6), respectively. Among the three sites - Caxias do Sul, São Paulo and Canoas - the sensitivity and specificity were respectively 94.7% and 97.8%; 71.4% and 93.9%, 82.1% and 88.9%. MAIN CONCLUSIONS These findings suggest that the Detect-TB assay could be applied routinely in reference laboratories across different regions in Brazil.

Assessment of Salvia officinalis(L) hydroalcoholic extract for possible use in cosmetic formulation as inhibitor of pathogens in the skin / Avaliação do extrato hidroalcoólico de Salvia officinalis(L) para possível uso em formulações cosméticas como inibidor de patógenos da pele

Salvia officinalis (L.), or common sage, is an aromatic herb that has been used in medicine and cooking since ancient times and has been investigated for the treatment of various diseases, especially infections and skin inflammation. We conducted phytochemical prospecting and quality control with hydroalcoholic extracts of dried sage, to identify active compounds in the plant. The aim was to assess antibacterial and antifungal activity against Staphylococcus aureus, Streptococcus agalactiae, Candida albicans and Candida tropicalis. Antimicrobial susceptibility was investigated in vitro by agar-overlay and well-diffusion techniques, in which disc and well were used. Salvia officinalis (L.) was not effective against Streptococcus agalactiae, Candida albicans or Candida tropicalis, but best results were observed for antibacterial activity against Staphylococcus aureus. Considering the results of the inhibition tests presented here, we suggest that cosmetic formulations containing Salvia officinalis (L.) could contribute to inhibitor of pathogens in the skin microbiota.

A Salvia officinalis (L.) é uma planta com uso difundido, utilizada no tratamento de diversas patologias, principalmente para infecções e inflamações cutâneas. Neste trabalho foi realizada prospecção fitoquímica e controle de qualidade com a planta seca e extrato hidroalcoólico para identificação dos compostos ativos da sálvia, tendo como finalidade comprovar sua atividade antibacteriana e antifúngica frente à Staphylococcus aureus, Streptococcus agalactiae Candida albicans e Candida tropicalis. Os métodos de escolha para avaliação in vitro foram ensaios de sensibilidade antimicrobiana por difusão em ágar com discos e cilindros. Dentre os ensaios realizados a sálvia não se mostrou efetiva para Streptococcus agalactiae, Candida albicans e Candida tropicalis, sendo o melhor resultado obtido com Staphylococcus aureus, em que se pode verificar-se atividade antibacteriana. Diante dos resultados obtidos, propôs-se uma formulação de sabonete líquido com extrato hidroalcoólico de Salvia officinalis (L.), para atuar na higiene da pele.

Nosocomial and community infections due to class A extended-spectrum β-lactamase (ESBLA)-producing Escherichia coli and Klebsiella spp. in southern Brazil

OBJECTIVES: To determine the prevalence of class A extended spectrum β-lactamases (ESBL)-producing Escherichia coli and Klebsiella spp., and to investigate clonality among ESBL-producing isolates of nosocomial and community infections. METHODS: The study involved 354 nosocomial infections samples and 992 community infections samples, obtained between 2003 and 2006 at Caxias do Sul, RS. The detection of ESBL was performed by the disk-diffusion test. Presence of blaCTX-M, blaSHV and blaTEM β-lactamase genes was evaluated by PCR, and genomic typing was determined by pulsed-field gel electrophoresis analysis. RESULTS: Higher frequency of ESBL-producing isolates were detected among nosocomial samples of E. coli (6.7 percent) and Klebsiella (43.7 percent), than those obtained from community infections (0.4 percent and 2.6 percent). blaTEM and blaCTX were the most prevalent ESBL gene families in both E. coli and Klebsiella isolates. Different pulsotypes were obtained among ESBL-producing E. coli and 11 clones for Klebsiella spp., which occurred over the years and in different hospital wards. Among ESBL-producing K. pneumoniae, 74.3 percent transferred ESBL genes by conjugation and exhibited concomitant decreased aminoglycosides susceptibility. CONCLUSION: ESBL-producing E. coli, and especially K. pneumoniae are essentially a nosocomial problem, and their dissemination to the community is relatively limited. The great genetic variability observed among ESBL-producing bacteria indicates polyclonal spread and high transference of ESBL genes between bacteria in the hospital environment. This information is of paramount importance for nosocomial infection control.

Aeromonas associated diarrhoeal disease in south Brazil: prevalence, virulence factors and antimicrobial resistance

Aeromonas were isolated from 27 (6.6 percent) of 408 patients admitted with acute gastroenteritis in two hospitals at Rio Grande do Sul, Brazil. Isolates were classified as A. hydrophila (51.8 percent), A. caviae (40.8 percent), and A. veronii biotype sobria (7.4 percent). The highest prevalence of Aeromonas associated infections occurred in lactants and children. Virulence genes (aerA -aerolysin/hemolysin, ahpA -serine-protease, satA - glycerophospholipid-cholesterol acyltransferase, lipA -lipase, and ahyB -elastase) and virulence factors (hemolytic, proteolitic, lipolitic activities, and biofilm formation) were identified in most A. hydrophila and A. veronii biotype sobria isolates, with lower frequencies on A. caviae. All Aeromonas isolates were resistant to ampicillin, ticarcillin/clavulanic acid, cephalotin, and cephazolin, and most of them (>70 percent) exhibited resistance to imipenem, carbenicillin, amoxillin/sulbactan, and piperacillin. Multiple-resistance, more than four antibiotics, was evidenced in 29.6 percent of the isolates. The most efficient antibiotics were the quinolones (ciprofloxacin and norfloxacin), and the aminoglycosides (amikacin and netilmicin).

Aeromonas foram isoladas de 27 (6.6 por cento) dos 408 pacientes admitidos com gastroenterite aguda em dois hospitais do Rio Grande do Sul, Brasil. Os isolados foram classificados com A. hydrophila (51.8 por cento), A. caviae (40.8 por cento), e A. veronii biotype sobria (7.4 por cento). A maior prevalência de Aeromonas ocorreu em lactantes e crianças. Genes (aerA -aerolisina/hemolisina, ahpA -serina-protease, satA - glicerofosfolipidio-colesterol aciltransferase, lipA -lipase, e ahyB -elastase) e factores (atividade hemolítica, proteolítica, lipolítica, e formação de biofilme) de virulência foram identificados na maioria dos isolados de A. hydrophila e A. veronii biotype sobria, com freqüências menores em A. caviae. Todos os isolados de Aeromonas apresentaram resistência a ampicilina, ticarcilina/ácido clavulânico, cefalotina e cefazolina, e a maior parte (>70 por cento) exibiram resistência a imipenem, carbenicilina, amoxacilina/sulbactam e piperacilina. Resistência múltipla foi evidenciada em 29,6 por cento dos isolados. Os antibióticos mais eficientes foram as quinolonas (ciprofloxacina e norfloxacina) e os aminoglicosídicos (amicacina e netilmicina).

Ocorrência de enteropatias em hortaliças, alface (Lactuca) e agriäo (nasturtium officinale) comercializadas em Caxias do Sul, RS, Brasil / occurence of intestinal disease in vegetable, lettuce (Lactuca sativa) and watercrass (Nasturtium officinale) commercialized in Caxias do Sul

Foram analisadas hortalicas, in natura, comercializadas em Caxias do Sul, RS, de marco a agosto de 1995, visando a identificacao e ocorrencia de formas de parasitas intestinais de interesse medico. As amostras foram manipuladas em laboratorio, segundo Oliveira e Germano (1992). Os resultados obtidos, de 8 amostras de alface (24 p,s) e 8 de agriao (16 macos) evidenciaram contaminacao de ovos de Ancylostomidae (43,8 por cento), Ascaris sp, (25,0 por cento), Trichiuris sp. (25,0 por cento), Enterobius sp, (6,3 por cento) e larvas de nematoides (75,0 por cento). Esses resultados mostraram a presenca de indicadores de mas condicoes higienico-sanitarias nas amostras analisadas, pois indicaram contaminacao fecal de origem humana e/ou animal, ressaltando a importancia das hortalicas na transmissao de parasitoses intestinais.