Extended-spectrum beta-lactamase-producing bacteria isolated from hematologic patients in Manaus, State of Amazonas, Brazil

Antibiotic therapy in hematologic patients, often weak and susceptible to a wide range of infections, particularly nosocomial infections derived from long hospitalization periods, is a challenging issue. This paper presents ESBL-producing strains isolated from such hematologic patients treated at the Amazon Hematology and Hemotherapy Foundation (HEMOAM) in the Brazilian Amazon Region to identify the ESBL genes carried by them as well as the susceptibility to 11 antimicrobial agents using the E-test method. A total of 146 clinical samples were obtained from July 2007 to August 2008, when 17 gram-negative strains were isolated in our institution. The most frequent isolates confirmed by biochemical tests and 16S rRNA sequencing were E. coli (8/17), Serratia spp. (3/17) and B.cepacia (2/17). All gram-negative strains were tested for extended-spectrum-beta-lactamases (ESBLs), where: (12/17) strains carried ESBL; among these, (8/12) isolates carried blaTEM, blaCTX-M, blaOXA, blaSHV genes, (1/12) blaTEM gene and (3/12) blaTEM, blaCTX-M, blaOXA genes. Antibiotic resistance was found in (15/17) of the isolates for tetracycline, (12/17) for ciprofloxacin, (1/17) resistance for cefoxitin and chloramphenicol, (1/17) for amikacin and (3/17) cefepime. This research showed the presence of gram-negative ESBL-producing bacteria infecting hematologic patients in HEMOAM. These strains carried the blaTEM, blaSHV, blaCTX-M and blaOXA genes and were resistant to different antibiotics used in the treatment. This finding was based on a period of 13 months, during which clinical samples from specific populations were obtained. Therefore, caution is required when generalizing the results that must be based on posological orientations and new breakpoints for disk diffusion and microdilution published by CLSI 2010.

Contaminação de halos doadores córneo-esclerais em ceratoplastia penetrante no Hospital de Clínicas de Porto Alegre / Positive corneoscleral rim culture in penetrating keratoplasty at the Porto Alegre Clinical Hospital

OBJETIVOS: Avaliar a incidência de positividade de culturas de halos doadores córneo-esclerais preservados em Optisol GS, identificar os patógenos envolvidos, a sensibilidade dos mesmos à gentamicina e a ocorrência de infecções em olhos receptores. MÉTODOS: Foram analisadas retrospectivamente 163 culturas de halos córneo-esclerais cujos botões corneanos foram utilizados em transplantes de córnea no Hospital de Clínicas de Porto Alegre entre janeiro de 2001 e janeiro de 2003. Os halos foram divididos em dois segmentos, metade inoculada em meio Sabouroud e a outra metade em tioglicolato, com posterior semeadura em ágar-sangue, ágar-chocoloate e meio de MacConkey, conforme necessidade para identificação dos patógenos. Os prontuários dos pacientes receptores foram revisados. RESULTADOS: Dos 163 halos analisados, 11 apresentaram culturas positivas, correspondendo a 6,7 por cento do total. Destes, quatro foram por Staphylococcus epidermidis, um por Staphylococcus aureus, um por Serratia sp, um por Pseudomonas aeruginosa e os outros quatro por diferentes subtipos de Candida (dois por Candida sp, um por Candida albicans e um por Candida parapapilosis). No antibiograma, todas as bactérias apresentaram-se resistentes à gentamicina. Nenhum olho que recebeu córnea com cultura positiva apresentou infecção após a cirurgia. CONCLUSÕES: Baixos índices de positividade de cultura de halos utilizados em transplantes de córnea no Hospital de Clínicas de Porto Alegre foram encontrados. Os patógenos mais freqüentemente identificados não apresentam boa cobertura pelos antimicrobianos presentes nos meios de preservação. A cultura de halos corneanos é recomendada para auxílio no tratamento de possível infecção ocular pós-cirúrgica.

PURPOSE: To determine the incidence of positive corneoscleral rim cultures preserved in Optisol GS medium, to identify pathogens involved and possible recipient eye infection. METHODS: A hundred sixty-three corneoscleral rim cultures penetrating keratoplasties performed from January 2001 to January 2003 in the Hospital de Clínicas de Porto Alegre were reviewed. Enucleations and corneal storage were done as aseptic as possible and gentamicin 0.3 percent was instilled. Corneoscleral rim was divided into two segments, half was inoculated into Sabouraud broth and the other half into thioglycolate broth; inoculation into blood agar, chocolate agar and MacConkey agar was done later if necessary for pathogen identification. The receiver's eye data were reviewed. RESULTS: There were eleven positive cultures (6.7 percent) out of 163 evaluated corneoscleral rim cultures. Of these, four were Staphylococcus epidermidis, one was Staphylococcus aureus, one was Serratia sp., one was Pseudomonas aeruginosa and the other four were different subtypes of Candida (two Candida sp., one Candida albicans and one Candida parapapilosis). All pathogens were resistant to gentamicin. None of the eleven cases of positive corneoscleral rim cultures resulted in ocular infection at the receiver's eyes (six months follow-up). CONCLUSIONS: We found low rates of positive corneoscleral rim cultures after penetrating keratoplasty at the Porto Alegre Clinical Hospital. The most frequent involved pathogens were Staphylococcus sp and Candida sp. Although we did not identify any postoperative infection at the receiver's eyes, we recommend corneoscleral rim culture for guidance of postoperative infection, a rare but possible devastating ocular event.

First isolation of microorganisms from the gut diverticulum of Aedes aegypti (Diptera: Culicidae): new perspectives for an insect-bacteria association

We show for the first time that the ventral diverticulum of the mosquito gut (impermeable sugar storage organ) harbors microorganisms. The gut diverticulum from newly emerged and non-fed Aedes aegypti was dissected under aseptic conditions, homogenized and plated on BHI medium. Microbial isolates were identified by sequencing of 16S rDNA for bacteria and 28S rDNA for yeast. A direct DNA extraction from Ae. aegypti gut diverticulum was also performed. The bacterial isolates were: Bacillus sp., Bacillus subtilis and Serratia sp. The latter was the predominant bacteria found in our isolations. The yeast species identified was Pichia caribbica.

Gram negative bacteria and contact lens induced acute red eye.

Two patients using hydrogel contact lenses on a daily wear schedule slept overnight with the lenses and woke up with a Contact Lens Induced Acute Red Eye (CLARE). The contact lenses recovered aseptically at the time of the event grew significant colonies of Pseudomonas aeruginosa and Aeromonas hydrophila in patient A and Pseudomonas aeruginosa and Serratia liquefaciens from patient B. Similar organisms from the contact lenses were recovered from the lens case and lens care solutions of patient B. In both the patients the condition resolved on discontinuation of lens wear. Patient compliance as a requirement for successful contact lens wear is highlighted with the illustration of these cases.

[Isolation of serratia marcescens from raw milk in tehran milk pasteruization plant]

Several nutrient agar plates with red colonies were dispathched to the laboratory from Tehran milk pasteurization plant which were cultured from milk samples. To determine the microbe, the colonies were streaked on the nutrient agar and incubated at 30°C for 24 hrs. The red round and smooth colonies with 1-2 mm in diameter developed on the agar surface which were transferred on TSI tubes and incubated at 30°C for 24 hrs. The result was yellowish [acid] reaction through the TSI tube with red pigment producing on the top of the tube. The smears were prepared and gram stained and polymorph gram negative bacteria observed which were analyzed by biochemical test such as lactose, Rhamnose, Sucrose, Citrate, Nitrate, Pepton water, MR-VP, Gelatine and Motility. The bacterium was identified Serratia marcescens which has an important role in the spoilage of the food e.g. milk and milk products and produces red pigments on the butter an other long life dairy products

Contaminación de catéteres endovenosos en un servicio pediátrico / Intravenous catheters contamination in a pediatric ward

La contaminación de los catéteres es una complicación común y a menudo inadvertida de la terapia endovenosa. Este estudio se efectuó para conocer la proporción de catéteres contaminados en nuestro medio, los gérmenes causales y algunos factores de riesgo asociados, en el Servicio de Pediatría del Hospital General de León, Gto. Se cultivaron, por rodamiento en agar, 116 catéteres obtenidos por simple disponibilidad (76 cortos y 40 largos). Se encontró una colonizacion global del 31.8 por ciento, con predominio de bacilos gramnegativos, seguidos por cocos grampositivos, La contaminación fue mayor para los catéteres largos que para los cortos (65 vs 14.4 por ciento, P<0.0001). Todos los catéteres cortos se habían aplicado por punción y todos los largos, por venodisección. Como factor asociado con la colonización de los catéteres largos se encontró el tiempo quirúrgico de venodisección mayor de 25 minutos. Para los cortos, los factores relacionados fueron la permanencia mayor de 72 horas y más de tres intentos fallidos en la aplicación. Se concluye en la necesidad de hacer conciencia del riesgo de la contaminación de la cateterización endovenosa, de contar con personal experto en la aplicación de catéteres y de preferir su aplicación por punción

Taxonomía numérica de bacterias aisladas del queso de cabra aplicando medios selectivos / Numerical taxonomy of bacteria isolated from goat cheese applying selective culture media

Mediante medios selectivos se aislaron 105 cepas bacterianas desde quesos de cabra, adquiridos en mercados locales de la ciudad de Valparaiso (Chile). Todas las cepas bacterianas junto a 4 de referencia, fueron examinadas para para 54 características fenotípicas, incluyendo pruebas morfológicas, fisiológicas y bioquímicas. Los resultados obtenidos fueron sometidos a un análisis numérico, utilizando el coeficiente de apareamiento simple Ssm. y la técnica de agrupación UPGMA. A nivel de semejanza de un 80 por ciento las cepas se agruparon en 8 fenómenos, representando a miembros de la familia enterobacteriaceae (7) y uno al género streptococcus

Microorganismos patogenos de hallazgo poco comun en infectologia / Pathogenic microorganisms not frecuently found in infectology

Se estudiaron los microorganismos de identificacion dificil referidos al laboratorio de bacteriologia del Instituto Nacional de Salud por 5 Instituciones. En 70 casos fue posible obtener una identificacion completa y responsabilizar al microorganismo aislado como agente etiologico de un cuadro clinico. Se trataba de 28 cuadros de septicemia, 26 de meningitis, 4 respiratorios, 7 genitourinarios y 6 varios que incluyeron heridas, abcesos, y conjuntivitis. Los identificados fueron: Serratia en el 38%, Acinetobacter en el 21.4%, Moraxella en el 10%, Alcaligenes en el 8.7%, Aeromonas en el 7.2%, Listeria en el 5.7%, Estreptobacilos en el 4.3% Corynebacterium en el 4.3%, Achromabacter, Cardiobacterium y los grupos M3 y M4 aparece cada uno con el 1.4% constituyendose en verdaderas curiosidades biologicas