Identificação de espécies de Staphylococcus coagulase negativa isoladas de queijo mussarela e fatiadores de frios / Identification of coagulase-negative Staphylococcus species isolated from mussarela cheese and cold-cut slicers

Espécies de Staphylococcus coagulase negativa também são encontradas como contaminantes em alimentos de origem animal. Este estudo teve como objetivo identificar espécies do grupo Staphylococcus coagulase negativa, isoladas de queijos Mussarela fatiados e fatiadores de frios. Foram identificadas nove espécies bacterianas, sendo as mais frequentes: Staphylococcus (S.) saprophyticus, representando 25,9% dos isolados, S. xylosus 18,4% e S. cohnii subsp. urealyticum 12,6%. As demais espécies identificadas foram: S. epidermidis, S. warneri, S. captis subsp. ureolyticus, S. chromogenes, S. caprae e S. simulans. É necessário salientar a importância das Boas Práticas de Manipulação e Higienização dos equipamentos fracionadores de queijo Mussarela, a fim de diminuir o risco de intoxicações alimentares causadas por microrganismos desse grupo.

Characterization of Coagulase-Negative Staphylococci and pheno-genotypic beta lactam resistance evaluation in samples from bovine Intramammary infection / Caracterização de Staphylococcus coagulase negativa e avaliação fenogenotípica da resistência aos beta-lactâmicos em amostras oriundas de infecção intra-mamária em bovinos

This study aimed to identify Coagulase-Negative Staphylococci (CoNS) species isolated from bovine mastitis, through phenotypic and PCR-RFLP (Restriction Fragment Length Polymorphism-Polimerase Chain Reaction) methods and to compare both techniques to matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) technique. Among them, the PCR-RFLP method, using a partially conserved sequence of the groEL gene, is a promising alternative, because of its reproducibility and reliability. On the other hand, the proteomic technique MALDI-TOF MS provides an accurate and much faster diagnosis and has been increasingly employed in microbiological identification. The pheno-genotypic profiles of beta-lactam resistance were also investigated, this characterization is important, considering that the use of antimicrobials is a key element for mastitis control in dairy farms. The concordance of the phenotypic, PCR-RFLP and MALDI-TOF MS assays to identify CoNS species was 77,5% (31/40). S. chromogenes was the species most frequently isolated. Antibiotic resistance rate was relatively low, registering values of 25.5% to penicillin, 9.6% to oxacillin and 6.2% to cefoxitin. Resistance to imipenem, cephalotin and amoxicillin+clavulanate was not observed. The mecA gene and its variant were detected in 7.6% and 4,1% of the isolates respectively. The blaZ gene was found in 43.2% of the strains resistant to penicillin.(AU)

Este estudo teve como objetivo identificar isolados de Staphylococcus coagulase-negativa (SCN) isolados de mastite bovina, por meio de métodos fenotípicos e PCR-RFLP (reação em cadeia de polimerase - polimorfismo nos fragmentos de restrição), e compará-los com a técnica de tempo de voo de ionização/desorção por laser assistida por matriz de espectrofotometria de massa (MALDI-TOF MS). O método de PCR-RFLP, que utiliza uma parte conservada da sequência do gene groEL, é uma alternativa promissora, por ser reprodutível e confiável. Por outro lado, a técnica proteômica MALDI-TOF MS permite uma acurácia e um diagnóstico muito mais rápidos e tem sido cada vez mais empregada na identificação microbiológica. Os perfis fenogenotípicos de resistência aos beta-lactâmicos também foram investigados. Essa caracterização é importante, considerando-se que os antimicrobianos são os elementos-chave para o controle da mastite na produção leiteira. A concordância entre os testes fenotípicos, PCR-RFLP E MALDI-TOF MS na identificação foi de 77,5% (31/40). S. chromogenes foi a espécie mais frequentemente isolada. A resistência antimicrobiana foi relativamente baixa, apresentando valores de 25,5% para penicilina, 9,6% para oxacilina e 6,2% para cefoxitina. Resistência ao imipenem, à cefalotina e à amoxacilina + ácido clavulâncico não foi observada. O gene mecA e sua variante foram detectados em 7,6% e 4,1% dos isolados, respectivamente. O gene blaZ foi encontrado em 43,2% dos isolados resistentes à penicilina.(AU)

Antimicrobial susceptibility profile and research of mec A and erm genes in coagulase-negative staphylococci isolated from platelet concentrates bags

Abstract In recent years, several studies have described the clinical impact of bacterial infection associated with transfusion of platelet concentrates (PCs). Among the blood components, PCs are responsible for the highest rates of bacterial contamination as well as septic transfusion reactions. We assessed antimicrobial susceptibility profile, resistance to methicillin (MRCoNS), and resistance to macrolides, lincosamides and streptogramins of group B (MLSB) of 16 coagulase-negative staphylococci (CoNS) isolates from an investigation in 691 PCs bags. We then compared conventional and automated phenotypic methods, disc diffusion test (DD) and VITEK(r) 2, respectively as well as phenotypic and genotypic methods (Polymerase Chain Reaction - PCR). All CoNS were susceptible to vancomycin. The disc diffusion test characterized 18.75% as MRCoNS and 37.5% with inducible resistance to MLSB (iMLSB), and with VITEK(r) 2, 6.3% and 31.25%, respectively. The mecA gene was detected in 18.75% and the erm gene in 31.25% of the isolates. In this study, we found equal percentage values between presence of the mecA gene by PCR and resistance to methicillin using cefoxitin by DD test, evidence of the erm gene by PCR, and iMLSB resistance by automation (VITEK(r) 2). Moreover, we identified three strains with beta-lactamase overproduction, and the occurrence of a bigger mistake was verified when automation was compared with DD test. And we observed that D-test was the most reliable for the detection of iMLSB resistance in Staphylococcus sp.

Coagulase-negative staphylococci in Southern Brazil: looking toward its high diversity

Abstract: INTRODUCTION: Coagulase-negative staphylococci (CoNS) are the most prevalent pathogens in nosocomial infections and may serve as a reservoir of mobile genetic elements such as the staphylococcal cassette chromosome mec (SCCmec) encoding methicillin resistance. Molecular characterization of SCCmec types combined with advanced molecular typing techniques may provide essential information for understanding the evolution and epidemiology of CoNS infections. We therefore aimed to investigate the SCCmec distribution, multidrug-resistance (MDR), and biofilm formation in CoNS blood culture isolates from a hospital in Southern Brazil. METHODS: We analyzed 136 CoNS blood culture isolates obtained during 2002-2004 from patients admitted to a tertiary care hospital in Brazil. SCCmec types I to V were determined using multiplex PCR. The clonal relationship of Staphylococcus epidermidis was determined using pulsed field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Molecular epidemiological data were interpreted along with data on biofilm formation, presence of the icaD gene, and MDR. RESULTS: The most prevalent species were S. epidermidis, Staphylococcus haemolyticus, and Staphylococcus hominis harboring mainly SCCmec types II, III, and V. Overall, the presence of multiple SCCmec was associated with non-MDR, except for S. epidermidis. S. epidermidis isolates showed a high prevalence of icaD, but had low phenotypic biofilm formation. PFGE and MLST revealed high genetic diversity in the S. epidermidis population. CONCLUSIONS: Our results suggest a major shift in SCCmec types within a short period and reveal a different behavior of S. epidermidis with regard to the association between the presence of multiple SCCmec types and MDR profile.

Prevalencia y sensibilidad a antibióticos de especies de estafilococos coagulasa negativos provenientes de mastitis subclínica en bovinos de tambos de la región central de Argentina / Prevalence and antibiotic susceptibility of coagulase-negative Staphylococcus species from bovine subclinical mastitis in dairy herds in the central region of Argentina

Coagulase-negative staphylococci (CNS) are a common cause of bovine subclinical mastitis (SCM). The prevalence of CNS species causing SCM identified by genotyping varies among countries. Overall, the antimicrobial resistance in this group of organisms is increasing worldwide; however, little information exists about a CNS species resistant to antibiotics. The aim of the present study was to genotypically characterize CNS at species level and to determine the prevalence and antibiotic resistance profiles of CNS species isolated from bovine SCM in 51 dairy herds located in the central region of the province of Cordoba, Argentina. In this study, we identified 219 CNS isolates at species level by PCR-restriction fragment length polymorphism of the groEL gene. Staphylococcus chromogenes (46.6%) and Staphylococcus haemolyticus (32%) were the most prevalent species. A minimum of three different CNS species were present in 41.2% of the herds. S. chromogenes was isolated from most of the herds (86.3%), whereas S. haemolyticus was isolated from 66.7% of them. The broth microdilution method was used to test in vitro antimicrobial susceptibility. Resistance to a single compound or two related compounds was expressed in 43.8% of the isolates. S. chromogenes and S. haemolyticus showed a very high proportion of isolates resistant to penicillin. Resistance to two or more non-related antimicrobials was found in 30.6% of all CNS. S. haemolyticus exhibited a higher frequency of resistance to two or more non-related antimicrobials than S. chromogenes.

Los estafilococos coagulasa negativos (ECN) son una causa frecuente de mastitis subclínica (MSC) en bovinos. La prevalencia de especies de ECN causantes de MSC identificadas por métodos genotípicos varía entre países. La resistencia antimicrobiana en este grupo de organismos se está incrementando en el mundo; sin embargo, existe poca información acerca de las especies de ECN resistentes a antibióticos. Los objetivos del presente estudio fueron caracterizar genotípicamente los ECN a nivel de especie y determinar la prevalencia y los perfiles de resistencia a antibióticos de las especies de ECN aisladas de MSC en bovinos de 51 rodeos situados en la provincia de Córdoba, Argentina. Mediante polimorfismos de los fragmentos de restricción del gen groEL identificamos 219 aislamientos de ECN a nivel de especie. Staphylococcus chromogenes (46,6%) y Staphylococcus haemolyticus (32%) fueron las especies más prevalentes. Un mínimo de 3 especies diferentes de ECN estuvieron presentes en el 41,2% de los tambos. S. chromogenes fue aislado en la mayoría de los tambos (86,3%), mientras que S. haemolyticus fue aislado en el 66,7% de aquellos. Para el análisis de sensibilidad a los antimicrobianos in vitro se usó el método de microdilución en caldo. La resistencia a un único compuesto o a 2 compuestos relacionados fue expresada en el 43,8% de los aislamientos. S. chromogenes y S. haemolyticus mostraron una muy elevada proporción de aislamientos resistentes a penicilina. La resistencia a 2 o más antimicrobianos no relacionados fue hallada en el 30,6% de los ECN. S. haemolyticus exhibió una frecuencia de resistencia a 2 o más antimicrobianos no relacionados más elevada que S. chromogenes.

INVESTIGATION OF BIOFILM FORMATION IN COAGULASE-NEGATIVE STAPHYLOCOCCI ISOLATED FROM PLATELET CONCENTRATE BAGS

Platelet Concentrates (PCs) are the blood components with the highest rate of bacterial contamination, and coagulase-negative staphylococci (CoNS) are the most frequently isolated contaminants. This study investigated the biofilm formation of 16 contaminated units out of 691 PCs tested by phenotypic and genotypic methods. Adhesion in Borosilicate Tube (ABT) and Congo Red Agar (CRA) tests were used to assess the presence of biofilm. The presence of icaADC genes was assessed by means of the Polymerase Chain Reaction (PCR) technique. With Vitek(r)2, Staphylococcus haemolyticus was considered the most prevalent CoNS (31.25%). The CRA characterized 43.8% as probable biofilm producers, and for the ABT test, 37.5%. The icaADC genes were identified in seven samples by the PCR. The ABT technique showed 85.7% sensitivity and 100% specificity when compared to the reference method (PCR), and presented strong agreement (k = 0.8). This study shows that species identified as PCs contaminants are considered inhabitants of the normal skin flora and they might become important pathogens. The results also lead to the recommendation of ABT use in laboratory routine for detecting biofilm in CoNS contaminants of PCs.

Eventos estressores na família e indicativos de problemas de saúde mental em crianças com idade escolar / Stressor events in the family environment that are indicative of mental health problems in children of school age

Resumo O objetivo deste artigo é avaliar a relação entre eventos estressores ocorridos no último ano na família de crianças e adolescentes com indicativos de problemas de saúde mental em uma amostra de estudantes de duas escolas de uma cidade no sul do Brasil. Estudo transversal com 1.075 estudantes matriculados em duas escolas públicas de ensino fundamental (uma estadual e outra municipal). Foi utilizado o Strengths and Difficulties Questionnaire para avaliação de fatores emocionais e comportamentais da criança, e a Escala de Avaliação de Reajustamento Social de Holmes e Rahe (1967) para avaliar os eventos estressores. Foram utilizados o teste qui-quadrado e a regressão de Poisson, com ajuste robusto para variância, expressando os resultados em razão de prevalências (RP) e intervalos de confiança de 95%. As chances de apresentar problemas de hiperatividade foram 1,42 (IC 95% 1,10-1,83) vezes maiores no tercil intermediário e 1,37 (IC 95% 1,06-1,78) no tercil superior, quando comparados ao tercil inferior. Quanto aos problemas de relacionamento, as chances foram de 1,49 (IC 95% 1,15-1,93) vezes maiores no tercil superior ao serem comparados com o tercil inferior. Os resultados sugerem que fatores ambientais podem ser fortemente relacionados à etiologia dos transtornos mentais na infância e adolescência.

Abstract The scope of this article is to evaluate the relationship between stressor events that occurred last year in the family of children and adolescents that are indicative of mental health problems in a sample of students from two schools in a city in southern Brazil. It involved a cross-sectional study with 1,075 students enrolled in two public elementary schools. The Strengths and Difficulties Questionnaire was used to assess emotional and behavioral factors of the child and the Social Readjustment Rating Scale (SRRS) of Holmes and Rahe (1967) to assess stressor events. The chi-square and Poisson regression test with robust variance adjustment for expressing the results in the prevalence ratio (PR) and confidence intervals of 95% were used. The chances of presenting problems of hyperactivity were 1.42 (95% CI 1.10 to 1.83) times higher in the intermediate tercile and 1.37 (95% CI 1.06-1.78) in the higher tercile compared with the lower tercile. With respect to relationship problems the chances were of 1.49 (95% CI 1.15 to 1.93) times higher in the higher tercile when compared with the lower tercile. The results suggest that environmental factors may be strongly related to the etiology of mental disorders in childhood and adolescence.

Halotolerant bacteria in the São Paulo Zoo composting process and their hydrolases and bioproducts

Halophilic microorganisms are able to grow in the presence of salt and are also excellent source of enzymes and biotechnological products, such as exopolysaccharides (EPSs) and polyhydroxyalkanoates (PHAs). Salt-tolerant bacteria were screened in the Organic Composting Production Unit (OCPU) of São Paulo Zoological Park Foundation, which processes 4 ton/day of organic residues including plant matter from the Atlantic Rain Forest, animal manure and carcasses and mud from water treatment. Among the screened microorganisms, eight halotolerant bacteria grew at NaCl concentrations up to 4 M. These cultures were classified based on phylogenetic characteristics and comparative partial 16S rRNA gene sequence analysis as belonging to the genera Staphylococcus, Bacillus and Brevibacterium. The results of this study describe the ability of these halotolerant bacteria to produce some classes of hydrolases, namely, lipases, proteases, amylases and cellulases, and biopolymers. The strain characterized as of Brevibacterium avium presented cellulase and amylase activities up to 4 M NaCl and also produced EPSs and PHAs. These results indicate the biotechnological potential of certain microorganisms recovered from the composting process, including halotolerant species, which have the ability to produce enzymes and biopolymers, offering new perspectives for environmental and industrial applications.

Comparative Study of Antibiotics and Allium Sativum Against Coagulase Positive and Coagulase Negative Staphylococcus.

Garlic (Allium sativum) is a well known medicine used since ancient times. Its potency as an antibiotic without inducing drug resistance has been well documented. A very common pyogenic organism, namely Staphylococcus aureus, as well as its coagulase negative brethren, are very well known pathogens causing infections all over the world. Their ability to become multidrug resistant has become a matter of deep concern to medical personnels all over the world. We wanted to see that garlic, described in various literatures as antiviral, antibacterial, antifungal, antiprotozoal, antioxidant – held how much potency as an antistaphylococcal agent as well. Aims and Objectives: The study aimed at evaluating the antistaphylococcal activity of garlic, in the face of emergence of multidrug resistant forms of both coagulase positive and negative forms of staphylococcus. Materials and Methods: Raw garlic juice was extracted and was tested to be sterile. Pure cultures of coagulase positive and negative staphylococcus were prepared. A comparative study using six potent antibiotics as well as garlic against Staphylococcus and CoNS strains was done. At the same time, decreasing concentrations of garlic solution was used to show the effect on zone of inhibition. Discussion: Both S.aureus and CoNS strains showed significant inhibition by garlic extract. Garlic seemed to have greater antibacterial effect than all the antibiotics tested except linezolid, which persistently performed better. With decreasing concentration of garlic juice, zone of inhibition also decreased consistently.

Sanitary quality, occurrence and identification of Staphylococcus sp: in food services

Sanitary conditions are essential for the production of meals and control of the presence of pathogensis important to guarantee the health of customers. The aim of this study was to evaluate the sanitary quality of food services by checking the presence of thermotolerant coliforms, Staphylococcus sp. and evaluate the toxigenic potential from the latter. The analysis was performed on water, surfaces, equipment, ready-to-eat foods, hands and nasal cavity of handlers in seven food services. The water used in food services proved to be suitable for the production of meals. Most food, equipment and surfaces showed poor sanitary conditions due to the presence of thermotolerant coliforms (60.6%). Twenty-six Staphylococcus species were identified from the 121 Staphylococcus isolates tested. Staphylococci coagulase-negative species were predominant in the foods, equipment and surfaces. In food handlers and foods, the predominant species was Staphylococcus epidermidis. Twelve different genotypes were found after PCR for the classical enterotoxin genes. The seb gene (19.8%) was the most prevalent among all Staphylococcus sp. Both coagulase-positive and coagulase-negative Staphylococci showed some of the genes of the enterotoxins tested. We conclude that there are hygienic and sanitary deficiencies in the food services analyzed. Although coagulase-positive Staphylococci have not been present in foods there is a wide dispersion of enterotoxigenic coagulase-negative Staphylococci in the environment and in the foods analyzed, indicating a risk to consumer health.

Significance of Coagulase Negative Staphylococci with Special Reference to Species Differentiation and Antibiogram.

Coagulase negative staphylococci (CoNS)are part of normal human flora increasingly recognized as significant nosocomial pathogens, infection often associated with implanted devices, joint prosthesis and different indwelling devices, especially in very young, old immunocompromised patients. Aims: To identify CoNS species, their distribution and antibiotic susceptibility pattern from different clinical samples. Method: A total 185 CoNS isolates were collected from various clinical samples followed for species identification by a practical scheme adapted using simple ,useful test selected from various references. Antibiotic susceptibility done by Kirby Bauer disc diffusion method. Results: The study yield that 185 CoNS,strains were isolated out of 1514 positive cultures from various clinical specimens. Among species ; S. epidermidis was the most commonly isolated species (68.65%), followed by S. heamolyticus (16.75%),followed by S. saprophyticus(9.8%)and few other species also identified. The antibiotic susceptibility pattern against commonly used antibiotic showed multidrug resistance with more than 90% resistance to penicillin and no strains was resistance to vancomycin. The methicillin resistance was 63% among all isolates of CoNS. Conclusions: Study suggest increasing pathogenic potential of CoNS as well as emerging of drug resistance amongst them, that necessitates the need to adopt simple laboratory procedure to identify CoNS species and understand definitive therapy for CoNS isolates from various clinical samples. This scheme was able to identified 98.9% isolates up to species level.

Evaluation of fuur different dna extraction metods in coagulase-negative staphhylococci clinical isolates / Avaliacao de quatro metodos diferentes de extracao de DNA em isolados clinicos de estafilococos coagulase negativos (SCoN)

Currently there are several methods to extract bacterial DNA based on different principles. However, the amount and the quality of the DNA obtained by each one of those methods is highly variable and microorganism dependent, as illustrated by coagulase-negative staphylococci (CoNS) which have a thick cell wall that is difficult to lyse. This study was designed to compare the quality and the amount of CoNS DNA, extracted by four different techniques: two in-house protocols and two commercial kits. DNA amount and quality determination was performed through spectrophotometry. The extracted DNA was also analyzed using agarose gel electrophoresis and by PCR. 267 isolates of CoNS were used in this study. The column method and thermal lyses showed better results with regard to DNA quality (mean ratio of A260/280 = 1.95) and average concentration of DNA (), respectively. All four methods tested provided appropriate DNA for PCR amplification, but with different yields. DNA quality is important since it allows the application of a large number of molecular biology techniques, and also it's storage for a longer period of time. In this sense the extraction method based on an extraction column presented the best results for CoNS.

Atualmente, para extrair o DNA bacteriano, existem diversos métodos baseados em diferentes princípios. Entretanto, a quantidade e qualidade do DNA obtido por cada um destes métodos é variável e depende do tipo de micro-organismo em questão; os estafilococos coagulase-negativos (CoNS), por exemplo, possuem parede celular espessa difícil de lisar. O objetivo deste estudo foi comparar a quantidade e a qualidade do DNA extraído de isolados clínicos de CoNS utilizando quatro metodologias diferentes: dois protocolos caseiros e dois kits comerciais. A determinação da quantidade e da qualidade do DNA foi realizada por espectrofotometria. O DNA extraído também foi analisado em eletroforese em gel de agarose e por PCR. A concentração média de DNA foi mais alta no método de lise térmica (). Entretanto, com relação à qualidade do DNA, o kit comercial que utiliza um método de extração baseado em uma coluna de separação apresentou melhor resultado (média da relação A260/280 = 1,95). As quatro técnicas testadas forneceram DNA passível de amplificação por PCR, porém com diferentes rendimentos. A qualidade do DNA extraído de bactérias é importante, pois possibilita a realização de maior número de técnicas de biologia molecular e também armazenamento do material por maior período de tempo. Neste sentido, a técnica de extração por coluna de separação apresentou melhor desempenho frente aos CoNS.

Methicillin-resistant coagulase-negative staphylococci from healthy dogs in Nsukka, Nigeria

The occurrence, resistance phenotype and molecular mechanisms of resistance of methicillin-resistant staphylococci from groin swabs of 109 clinically healthy dogs in Nsukka, Nigeria were investigated. The groin swab samples were cultured on mannitol salt agar supplemented with 10 µgof cloxacillin. Sixteen methicillin-resistant coagulase negative staphylococci (MRCoNS), all harbouring the mecA gene were isolated from 14 (12.8%) of the 109 dogs studied. The MRCoNS isolated were: S. sciuri subspecies rodentium, S. lentus, S. haemolyticus, and S. simulans with S. sciuri subspecies rodentium (62.5%) being the predominant species. Thirteen (81.3%) of the MRCoNS were resistant to tetracycline while 12 (75%) and 10 (62.5%) were resistant to kanamycin and trimthoprim-sulphamethoxazole respectively. None of the isolates was resistant to fusidic acid, linezolid and vancomycin. Thirteen (81.3%) of the MRCoNS were multi-drug resistance (MDR). Other antimicrobial genes detected were: blaZ, tet(K), tet(M), tet(L), erm(B), lnu(A), aacA-aphD, aphA3, str, dfr(G), cat pC221,and cat pC223. Methicillin-resistant staphylococci are common colonizers of healthy dogs in Nigeria with a major species detected being S. sciuri subsp. rodentium.

Bacteremia due to Staphylococcus cohnii ssp. urealyticus caused by infected pressure ulcer: case report and review of the literature / Bacteremia por Staphylococcus cohnii ssp. urealyticus devida a úlcera de pressão infectada: relato de caso e revisão da literatura

Coagulase-negative staphylococci are common colonizers of the human skin and have become increasingly recognized as agents of clinically significant nosocomial infections.

The case of a 79-year-old male patient with multi-infarct dementia who presented systemic inflammatory response syndrome is reported. This was attributed to bacteremia due to Staphylococcus cohnii ssp. urealyticus, which was grown on blood cultures originating from an infected pressure ulcer. The few cases of Staphylococcus cohnii infection reported in the literature consist of bacteremia relating to catheters, surgical prostheses, acute cholecystitis, brain abscess, endocarditis, pneumonia, urinary tract infection and septic arthritis, generally presenting a multiresistant profile, with nearly 90% resistance to methicillin.

The reported case is, to our knowledge, the first case of true bacteremia due to Staphylococcus cohnii subsp. urealyticus caused by an infected pressure ulcer. It shows that this species may be underdiagnosed and should be considered in the differential diagnosis for community-acquired skin infections. .

Staphylococcus coagulase-negativos, colonizadores frequentes da pele humana, têm sido reconhecidos como agentes de infecções nosocomiais.

Relata-se o caso de um paciente de 79 anos com demência vascular que apresentou síndrome da resposta inflamatória sistêmica atribuída a bacteremia por Staphylococcus cohnni ssp. urealyticus, que cresceu em hemoculturas, secundária a uma úlcera de pressão infectada. Os poucos casos de infecção por Staphylococcus cohnii relatados na literatura descrevem bacteremia associada a cateter, próteses cirúrgicas, colecistite aguda, abscesso cerebral, endocardite, pneumonia, infecção do trato urinário e artrite séptica, geralmente apresentando um perfil de multirresistência, com aproximadamente 90% de resistência à meticilina.

O caso relatado é, ao nosso conhecimento, o primeiro de bacteremia verdadeira por Staphylococcus cohnii subsp. urealyticus causada por uma úlcera por pressão, mostrando que esta espécie pode estar subdiagnosticada e deveria ser considerada no diagnóstico diferencial das infecções cutâneas adquiridas na comunidade. .

Prevalence and risk factors for carriage of multi-drug resistant Staphylococci in healthy cats and dogs

We investigated the distribution of commensal staphylococcal species and determined the prevalence of multi-drug resistance in healthy cats and dogs. Risk factors associated with the carriage of multi-drug resistant strains were explored. Isolates from 256 dogs and 277 cats were identified at the species level using matrix-assisted laser desorption ionisation-time of flight mass spectrometry. The diversity of coagulase-negative Staphylococci (CNS) was high, with 22 species in dogs and 24 in cats. Multi-drug resistance was frequent (17%) and not always associated with the presence of the mecA gene. A stay in a veterinary clinic in the last year was associated with an increased risk of colonisation by multi-drug resistant Staphylococci (OR = 2.4, 95% CI: 1.1~5.2, p value LRT = 0.04). When identifying efficient control strategies against antibiotic resistance, the presence of mechanisms other than methicillin resistance and the possible role of CNS in the spread of resistance determinants should be considered.

Colonización bacteriana de piel sana versus quemada de niños bajo 15 años tratados en COANIQUEM, Santiago de Chile / Bacterial colonization in areas of burnt skin and healthy children younger than 15 years, seen COANIQUEM, Santiago, Chile

Bacterial colonization in patients with burns skin without infection and outpatient management has been poorly studied. Objective: To quantify and identify the type of bacteria that colonize healthy body areas homologous location of the skin in children from 1 to 15 years, seen COANIQUEM, Santiago, Chile. Per patient, we studied 204 samples from each zone. The isolated microorganisms were S. epidermidis 35, 3%; others Staphylococcus coagulase negative, 25.8%; S. aureus, 4.4%; and S. viridans group 1.4%. In the subgroup of children who had a count between 1 and 1000 cfu, there was a higher proportion of cfu in burned skin healthy skin (p = 0.0359). The association between depth of the lesion and the bacterial count obtained p = 0.034. Conclusion: In outpatient treatment, the microorganisms are expected in healthy skin, burned skin is evident in lower counts probably associated with epithelial damage.

La colonización bacteriana de la piel de pacientes quemados, sin infección y de manejo ambulatorio, ha sido escasamente estudiada. Objetivo: Cuantificar e identificar el tipo de bacterias que colonizan las zonas cruentas y las zonas sanas de localización homóloga de la piel, en niños entre uno y 15 años de edad que son tratados de forma ambulatoria en la Corporación de Ayuda al Niño Quemado (COANIQUEM) en Santiago de Chile. Pacientes y Métodos: Se estudiaron 204 pacientes quemados en los que se tomó una muestra para cultivo desde la zona de la quemadura y otra desde el sitio homólogo sin quemadura. Resultados: Las especies bacterianas aisladas desde ambos tipos de muestra fueron similares: Staphylococcus epidermidis; otras especies de Staphylococcus coagulasa negativa; Staphylococcus aureus, y Streptococcus grupo viridans. El recuento bacteriano de uno a 999 ufc/ 10,5 cm² fue significativamente superior en las muestras de piel sana (p = 0,0359). La asociación entre mayor profundidad de la lesión y el menor recuento bacteriano obtuvo un p = 0,034. Conclusión: En niños quemados de entre uno y 15 años, de manejo ambulatorio, los microorganismos que colonizan la zona quemada fueron los mismos que colonizan la piel sana, pero en recuento inferior.

The Causes and Treatment Outcomes of 91 Patients with Adult Nosocomial Meningitis

BACKGROUND/AIMS: Frequent pathogens of nosocomial meningitis were investigated and the adequacy of empiric antibiotic therapy was assessed. Outcomes of nosocomial meningitis were also evaluated. METHODS: Ninety-one patients, who were diagnosed and treated for nosocomial meningitis at a single tertiary hospital in Daegu, Korea for 10 years, were included. Medical record and electronic laboratory data on the causative pathogens, antibiotics used, and outcomes were retrospectively investigated. RESULTS: Coagulase-negative Staphylococcus (40.9%) was the most common pathogen, followed by Acinetobacter (32.5%). Both were cultured as a single organism in cerebrospinal fluid (CSF). Seventy-eight patients (85.7%) had infections related to external ventricular drains (EVD). The most common empirical antibiotics were extended-spectrum beta-lactam antibiotics plus vancomycin (35/91, 38.6%). Of the 27 patients who had cultured Acinetobacter in CSF, 10 (37%) were given the wrong empirical antibiotic treatment. Seven of the 27 patients (26.9%) with cultured Acinetobacter died, and overall mortality of the 91 patients was 16.5%. In the multivariate analysis, the presence of combined septic shock (p < 0.001) and a persistent EVD state (p = 0.021) were associated with a poor prognosis. CONCLUSIONS: Acinetobacter is one of the leading pathogens of nosocomial meningitis and may lead to inadequate coverage of empiric antibiotic therapy due to increasing resistance. An EVD should be removed early in cases of suspected nosocomial meningitis, and carbapenem might be required for the poor treatment response.

Sepsis due to linezolid resistant Staphylococcus cohnii and Staphylococcus kloosii: First reports of linezolid resistance in coagulase negative staphylococci from India.

Linezolid, a viable alternative to vancomycin against methicillin resistant staphylococcal isolates, has been in use for a decade around the globe. However, resistance against staphylococci remains extremely rare and unreported from most of the Asian countries. Herein, we report two cases of linezolid resistant, coagulase negative staphylococcal sepsis for the first time from India. The first case was an 18-year-old burn patient, who, after a major graft surgery, landed in sepsis, and linezolid resistant Staphylococcus cohnii with an minimum inhibitory concentration (MIC) of >256 μg/ml by both broth microdilution and Etest, was isolated from multiple blood cultures. The second patient was a 60-year-old male with an intracranial bleed and sepsis, from whose blood cultures, linezolid resistant Staphylococcus kloosii was repeatedly isolated. Linezolid MIC was >32 μg/ml by broth microdilution and >16 μg/ml by Etest.

Bacteremias por Staphylococcus coagulase negativos oxacilina resistentes em um hospital escola na cidade de Santa Maria, Estado do Rio Grande do Sul / Oxacillin-resistant coagulase-negative Staphylococci bacteremia at a teaching hospital in Santa Maria, State of Rio Grande do Sul, Brazil

INTRODUÇÃO: Neste estudo, objetivou-se caracterizar a prevalência e o perfil de suscetibilidade de cepas de Staphylococcus coagulase negatives resistentes à oxacilina isoladas de culturas de sangue, em um hospital escola, localizado na Cidade de Santa Maria. Além disso, buscou-se comparar ao teste genotípico de referência, diferentes metodologias fenotípicas para a caracterização da resistência mediada pelo gene mecA. MÉTODOS: Após identificação (MicroScan® - Siemens), os isolados foram submetidos a testes de sensibilidade antimicrobiana a partir da difusão do disco e automação (MicroScan® - Siemens). A presença do gene mecA foi evidenciada através da técnica molecular de reação em cadeia da polimerase. RESULTADOS: A espécie prevalente foi Staphylococcus epidermidis (67 por cento). O gene mecA foi detectado em 90 por cento das cepas e conforme análise dos perfis de sensibilidade, observou-se um índice elevado de resistência a várias classes de antimicrobianos. Contudo, todos os isolados mostraram-se uniformemente sensíveis à vancomicina e tigeciclina. O disco de cefoxitina foi a metodologia fenotípica que melhor correlacionou-se com o padrão ouro. CONCLUSÕES: A análise da significância clínica de SCN isolados de hemoculturas e a detecção precisa da resistência à oxacilina representam fatores decisivos para a instituição correta da antibioticoterapia. Apesar da vancomicina constituir o tratamento usual na maioria dos hospitais brasileiros, tem a redução de seu emprego recomendada.

INTRODUCTION: This study aimed to characterize the prevalence and susceptibility profile to oxacillin-resistant Coagulase-negative Staphylococci strains isolated from blood cultures in a teaching hospital, located in Santa Maria, RS. In addition, different methodologies for phenotypic characterization of mecA-mediated oxacillin resistance were compared with genotypic reference testing. METHODS: After identification (MicroScan® - Siemens), the isolates were tested for antimicrobial sensitivity using disk diffusion and automation (MicroScan® - Siemens). The presence of mecA gene was identified by the polymerase chain reaction molecular technique. RESULTS: The most common species was Staphylococcus epidermidis (n=40, 67 percent). The mecA gene was detected in 54 (90 percent) strains, while analysis of the sensitivity profiles revealed a high rate of resistance to multiple classes of antimicrobial drugs. However, all isolates were uniformly sensitive to vancomycin and tigecycline. The cefoxitin disk was the phenotypic method that best correlated with the gold standard. CONCLUSIONS: Analysis of the clinical significance of CoNS isolated from hemocultures and the precise detection of oxacillin resistance represent decisive factors for the correct choice of antibiotic therapy. Although vancomycin constitutes the normal treatment in most Brazilian hospitals, reduction in its use is recommended.