Microbial source tracking and antimicrobial resistance in one river system of a rural community in Bahia, Brazil / Rastreamento de fontes microbianas e resistência antimicrobiana em um sistema fluvial de uma comunidade rural da Bahia, Brasil

Use of antibiotics inevitably leads to antimicrobial resistance. Selection for resistance occurs primarily within the gut of humans and animals as well as in the environment through natural resistance and residual antibiotics in streams and soil. We evaluated antimicrobial resistance in Gram negative bacteria from a river system in a rural community in Bahia, Brazil. Water was collected from the Jiquiriçá and Brejões rivers and the piped water supply. Additionally, stools were collected from a random sample of residents, cows, pigs and horses near the river. The samples were screened for bacteria resistant to ciprofloxacin, cefotaxime, and meropenem and identified biochemically at the genus and species levels. Microbial source tracking demonstrated that ruminant and human fecal contamination increased as the rivers neared the village center and decreased after the last residence. Antibiotic bacteria were identified from all samples (n = 32). No bacteria were resistant to carbapenems, but the majority of the enterobacteria were resistant to ciprofloxacin, even though this class of antibiotics is not commonly used in food animals in this region. Considering these facts, together with the pattern of human fecal contamination, a human source was considered most likely for these resistant isolates.

O uso de antibióticos inevitavelmente leva à resistência antimicrobiana. A seleção para resistência antimicrobiana ocorre principalmente no intestino de seres humanos e animais, bem como no meio ambiente, através da resistência natural e resíduos de antibióticos nos esgotos e no solo. Avaliamos a resistência antimicrobiana em bactérias Gram-negativas de um sistema fluvial em uma comunidade rural da Bahia, Brasil. A água foi coletada nos rios Jiquiriçá e Brejões e no abastecimento de água encanada. Além disso, foram coletadas amostras randomizadas de fezes de moradores, vacas, porcos e cavalos próximos ao rio. As amostras foram triadas para bactérias resistentes à ciprofloxacina, cefotaxima e meropenem e identificadas bioquimicamente nos níveis de gênero e espécie. O rastreamento de fontes microbianas demonstrou que a contaminação fecal de ruminantes e humanos aumentou à medida que os rios se aproximavam do centro da vila e diminuía após a última residência. Bactérias resistentes a antibióticos foram identificadas em todas as amostras (n = 32). Nenhuma bactéria demonstrou ser resistente aos carbapenêmicos testados, contudo, foi encontrado enterobactérias resistentes à ciprofloxacina, ainda que essa classe de antibióticos não seja comumente usada na medicina veterinária dos animais dessa região. Considerando esses fatos, juntamente com o padrão de contaminação fecal avaliado, a fonte de contaminação humana foi considerada a mais provável na interação desses isolados resistentes.

Use of MALDI-TOF for identification and surveillance of gramnegative bacteria in captive wild psittacines / Uso do MALDI-TOF para identificação e monitoramento de bactérias Gram negativas em psitacídeos cativos

Microbiological studies of the sanitary and health status of psittacine birds that will be reintroduced is important in evaluating whether these animals act as carriers of pathogenic agents to other animals and humans. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) is a faster and more accurate method to identify bacteria than conventional microbiology methods. The aim of this study was to evaluate the health status of psittacines housed in captivity, by assessment of Gram-negative bacteria from fecal microbiota through MALDI- TOF MS identification. The results indicate high frequency of Gram-negative bacteria in feces (96.5%), especially from the Enterobacteriaceae family (88.7%). The most prevalent bacteria were Escherichia coli (39.0%), Proteus vulgaris (12.2%), Klebsiella spp. (12.1%) and Raoultella ornithinolytica (8.7%). Proteus hauseri, Citrobacter spp., Morganella morgannii, Providencia rettgeri, Enterobacter spp. and Escherichia hermannii were isolated with lower frequency. . All these agents are potentially pathogenic for parrots and can cause systemic infections in other animals and humans. These findings reinforce that MALDI- TOF MS proved to be a rapid and accurate method of identification of the microorganism and evaluation of the health status of psittacines, providing relevant data to assist decision-making regarding the sanitary protocols in wildlife centers, and possible future reintroduction of wild birds.

Estudos microbiológicos da sanidade de psitacídeos que serão reintroduzidos são importantes para avaliar se esses animais atuam como portadores de agentes patogênicos para outros animais e humanos. A espectrometria de massa por ionização/dessorção de matriz assistida por laser/tempo de vôo (MALDI-TOF MS) é um método mais rápido e preciso para identificar bactérias na comparação com métodos convencionais de microbiologia. O objetivo deste estudo foi avaliar o estado de saúde de psitacídeos cativos, identificando bactérias Gram-negativas da microbiota fecal por MALDI -TOF MS. Os resultados indicaram alta frequência de bactérias Gram-negativas nas fezes (96,5%), principalmente da família Enterobacteriaceae (88,7%). As mais prevalentes foram Escherichia coli (39,0%), Proteus vulgaris (12,2%), Klebsiella spp. (12,1%) e Raoultella ornithinolytica (8,7%). Proteus hauseri, Citrobacter spp., Morganella morgannii, Providencia rettgeri, Enterobacter spp. e Escherichia hermannii foram isolados com menor frequência. Todos esses agentes são potencialmente patogênicos para os papagaios e podem causar infecções sistêmicas em outros animais e seres humanos. Esses achados reforçam que o MALDI- TOF MS é um método rápido e preciso de identificação do microrganismo e avaliação do estado de saúde dos psitacídeos, fornecendo dados relevantes para auxiliar na tomada de decisões sobre os protocolos sanitários em centros de triagem de animais selvagens e sobre a possibilidade de reintrodução futura.

Ocorrência de Campylobacter e Enterobacteriaceae em aves silvestres e frangos de corte / Campylobacter and Enterobacteriaceae in wild birds and poultry

As aves silvestres podem ser reservatório de bactérias patogênicas e atuar como veiculadoras desses microrganismos para o ambiente, os animais domésticos e o homem. Portanto, o objetivo deste trabalho foi verificar a ocorrência de Campylobacter spp., Yersinia enterocolitica e Salmonella enterica em aves silvestres capturadas nas áreas próximas de aviários e em frangos de corte alojados nesses estabelecimentos, além de verificar a presença dos genes cdtA, cdtB e cdtC nos isolados de Campylobacter e identificar os sorotipos de Salmonella encontrados. Amostras de fezes de 189 aves silvestres capturadas com redes de neblina nas áreas próximas de 10 aviários e de 200 frangos de corte foram processadas para pesquisa de Campylobacter spp., S. enterica e Y. enterocolitica. Duas espécies de aves silvestres, Sicalis flaveola (canário-da-terra) e Zonotrichia capensis (tico-tico), foram positivas para Salmonella e Campylobacter, respectivamente. Foram isolados Campylobacter spp., S. enterica e Y. enterocolitica de frangos. Todos os isolados de Campylobacter analisados apresentaram os genes cdt. Em dois aviários, Campylobacter foi isolado tanto de frangos como de aves silvestres, entretanto a contaminação mútua entre essas aves não foi comprovada. Este foi o primeiro relato de isolamento de Campylobacter de Z. capensis e de Salmonella do sorotipo Derby de S. flaveola.(AU)

Wild birds can be reservoirs of pathogenic bacteria and act as carriers of these microorganisms to the environment, domestic animals, and humans. Therefore, this study had as objective to verify the occurrence of Campylobacter spp., Yersinia enterocolitica and Salmonella enterica in wild birds captured in the surroundings of the aviaries and in the broilers housed in these establishments. The presence of the cdtA, cdtB and cdtC genes in Campylobacter isolates was also investigated and Salmonella serotypes were identified. Stool samples from 189 wild birds captured with mist nets in around 10 aviaries and from 200 broilers were processed for Campylobacter spp., S. enterica and Y. enterocolitica research. Two species of wild birds, Sicalis flaveola (Saffron Finch) and Zonotrichia capensis (Rufous-collared Sparrow) were positive for Salmonella and Campylobacter, respectively. Campylobacter spp., S. enterica and Y. enterocolitica were isolated from broilers. The cdt genes were found in all Campylobacter isolates. In two aviaries, Campylobacter was isolated from both broilers and wild birds, however the mutual contamination among these birds has not been shown. This was the first report of Campylobacter isolation from Z. capensis and of Derby Salmonella serotype isolation from S. flaveola.(AU)

Enterobacterias portadoras de KPC en un hospital universitario / KPC-producing Enterobacteriaceae in a university hospital

La resistencia a carbapenemes en enterobacterias representa una situación de alto impacto clínico debido a las limitadas opciones terapéuticas disponibles para el tratamiento de las infecciones causadas por estos microorganismos multirresistentes que cursan con altas tasas de morbilidad y mortalidad. En nuestro país, en los últimos 5 años, se observó la diseminación de aislamientos de Klebsiella pneumoniae portadores de carbapenemasa de tipo KPC pertenecientes al ST258, clon diseminado mundialmente. En nuestro hospital la incidencia de episodios fue aumentando, especialmente la infección del sitio quirúrgico y las bacteriemias. En el último bienio se observó la diseminación del mecanismo de resistencia a otras enterobacterias y probablemente a otros secuenciotipos de K pneumoniae con mayor sensibilidad a antibióticos no ß-lactámicos. Se hace necesario instaurar las correctas medidas de prevención y control para evitar la diseminación de estos patógenos.

The presence of carbapenem -resistant Enterobacteriaceae in clinical settings represents a concerning issue due to the limited therapeutic options available for the treatment of the infections caused by these multi-drug resistant bacteria which usually have high mortality rates. The spread of Klebsiella pneumoniae isolates belonging to ST258 was observed in the last 5 years in our country. In our hospital the number of episodes has grown with the years and the most prevalent infections were the surgical site and bacteremia. In the last 2 years KPC spread to other Enterobacteriaceae and probably to other STs in K pneumoniae which showed different susceptibility patterns to non ß-lactamic antimicrobials. We believe that it is vital to install the appropriate measures to prevent and control the dissemination of these microorganisms.

Pesquisa de enterobactérias em patos domésticos (Cairina moschata) de propriedades localizadas em quatro municípios do Ceará, Brasil / Survey of Enterobacteriaceae in domestic ducks (Cairina moschata) from properties located in four cities of the state of Ceará, Brazil

O objetivo deste trabalho foi isolar e identificar as enterobactérias presentes em patos domésticos (Cairina moschata) de propriedades localizadas em quatro municípios no estado do Ceará. Para isso, 47 esfregaços cloacais foram realizados, e 65 amostras de fezes de patos criados em propriedades localizadas nos municípios de Fortaleza, Boa Água, Eusébio e Cascavel foram coletadas. As amostras foram submetidas ao processamento microbiológico. No pré-enriquecimento, todas as amostras de fezes e dos esfregaços cloacais coletados foram alocadas em água peptonada tamponada 0,1%. Para o enriquecimento seletivo, alíquotas da água peptonada com as amostras foram transferidas para tubos contendo Rappaport-Vassilliadis e Selenito-Cistina. Placas de Verde-Brilhante e MacConkey foram semeadas com o conteúdo dos tubos do enriquecimento. Colônias suspeitas escolhidas com base em características morfológicas foram semeadas em provas bioquímicas (TSI: Tríplice Açúcar Ferro; LIA: Ágar Lisina Ferro; e SIM: Sulfeto, Indol, Motilidade). As bactérias foram identificadas com base nas características bioquímicas. Foi detectado, a partir do exame microbiológico, que as enterobactérias mais prevalentes isoladas das amostras de esfregaços cloacais e de fezes foram Citrobactersp., Proteus sp. e Enterobacter sp. Em menor frequência ocorreram Klebsiella sp., Hafnia sp., Escherichia coli, Shigella sp., Edwardsiella sp., Providencia sp. e Serratia sp. De acordo com a metodologia utilizada, concluiu-se que a microbiota intestinal dos patos avaliados não apresentava Salmonella sp., gênero bacteriano comumente associado a esta espécie de ave; entretanto, observou-se que a fauna microbiana era constituída pelas principais enterobactérias comuns a outras espécies de aves, sendo algumas potencialmente patogênicas aos animais e aos seres humanos.(AU)

This study aimed to isolate and identify members of the Enterobacteriaceae that were present in domestic ducks (Cairina moschata) from properties located in four cities in the State of Ceará, Brazil. Therefore, 65 stool samples and 47 cloacal swabs were collected from farms located in the following cities: Fortaleza, Boa Água, Eusébio and Cascavel. The samples were submitted to bacteriological processing. In pre-enrichment, all of the stool and swab samples were cultured in buffered peptone water 0.1%. For selective enrichment, aliquots from the tubes of the prior step after incubation were transferred to tubes containing Rappaport-Vassiliadis and Selenite Cystine broths. Plates with MacConkey and Brilliant Green agars were streaked with the content from the enrichment tubes after incubation. Colonies were chosen based on their morphological characteristics for the biochemical tests (TSI: Triple-Sugar-Iron; LIA: Lysine-Iron-Agar; and SIM: Sulfide-indole-motility). The bacteria were identified based on their biochemical characteristics. The mostly isolated bacteria were Citrobacter sp., Proteus sp., and Enterobacter sp. In a lower frequency, isolated enterobacteria were Klebsiella sp., Hafnia sp., Escherichia coli, Edwardsiella sp., Providencia sp. and Serratia sp. With the methodology applied, no Salmonella was isolated from the evaluated ducks, which is a genus commonly associated with this avian species; however the microbiota were composed by the main enterobacteria that are common to other species of birds, some of which are potentially pathogenic both to animals and humans.(AU)

Correlación entre las características clínicas y el tipo de agente enteropatógeno bacteriano en menores de 5 años con diarrea aguda, atendidos en el Hospital de Emergencias Pediátricas durante el año 2013 / Correlation between clinical characteristics and the type of agent bacterial enteropathogens in children less than 5 years with acute diarrhea attended at the Hospital of Pediatric Emergency in 2013

Determinar la correlación entre las características clínicas y el tipo de agente enteropatógeno bacteriano en menores de 5 años con diarrea aguda infecciosa atendidos en el Hospital de Emergencias Pediátricas durante el año 2013. Metodología: El estudio es observacional, analítico comparativo, retrospectivo y transversal. Se realizó la investigación sobre la muestra de 362 niños menores de 5 años con diagnóstico de Diarrea Aguda. Para relacionar las variables se utilizó la prueba Chi-cuadrado. Resultados: De las características generales de los pacientes pediátricos en estudio, la edad promedio fue 30.02±21.7 meses (2 años y medio), en su mayoría masculino (55.5 por ciento), gran parte vive en el distrito de San Juan de Lurigancho, con un nivel socioeconómico medio y con mayor frecuencia estos cuadros diarreicos ocurren en primavera. Con respecto a las características nutricionales, el peso actual de los pacientes menores de 5 años con diarrea aguda fue de 12.8±8.12 kg en promedio. Además, sólo el 3.6 por ciento manifestó que su alimentación fue adecuada. Las características sintomatológicas más frecuentes que presentaron los menores fueron fiebre (68.8 por ciento), palidez (61 por ciento), dolor abdominal (54.1 por ciento) y vómito (46.4 por ciento); y los menos frecuentes fueron disentería y convulsiones. El grado de deshidratación fue mayormente leve (67.1 por ciento). En cuanto al tiempo de evolución de la diarrea este fue de 47.7±52.7 horas, el promedio de deposiciones fue de 3.9 veces al día y el promedio de vómitos fue 2.8 veces al día. Entre los principales enteropatógenos responsables de la diarrea aguda en niños menores de 5 años fueron Campylobacter (57.5 por ciento) y Shigella (34.3 por ciento), y en menor porcentaje el E. Coli y la Salmonella. Además, el dolor abdominal, la fiebre, el vómito los escalofríos y el grado de deshidratación estuvieron relacionados con algún tipo de bacteria (p<0.05). Por otro lado, la mayoría de pacientes...

To determine the correlation between clinical characteristics and the type of bacterial enteropathogen in children younger than 5 years with acute infectious diarrhea treated at the Pediatric Emergency Hospital during 2013. Methodology: Observational, comparative, retrospective, analytical, transversal study. The sample was 362 children younger than 5 years diagnosed with Acute Diarrhea. To relate the variables, the chi-square test was used. Results: The general characteristics of pediatric patients studied were: the mean age was 30.02±21.7 months (2 1/2 years), mostly male (55.5 per cent), Most live in the district of San Juan de Lurigancho, with middle socioeconomic level and most often these diarrheas occur in spring. Regarding the nutritional characteristics, current weight of patients younger than 5 years with acute diarrhea was 12.8 ± 8.12 kg on average. Furthermore, only 3.6 per cent said that their food was adequate. The most frequent symptomatology characteristics that children had were fever (68.8 per cent), pallor (61 per cent), abdominal pain (54.1 per cent) and vomiting (46.4 per cent); and least frequent were dysentery and seizures. The degree of dehydration was mostly mild (67.1 per cent). Regarding the duration of the diarrhea was 47.7±52.7 hours, the average deposition was 3.9 times per day and the average of vomiting was 2.8 times a day. The main enteropathogens responsible for acute diarrhea in children younger than 5 years were Campylobacter (57.5 per cent) and Shigella (34.3 per cent) and in the lowest percentage E. Coli and Salmonella. In addition, abdominal pain, fever, chills, vomiting and degree of dehydration were related to some type of bacteria (p<0.05). Moreover, the majority of patients (51.9 per cent) had more than 100 fecal leukocytes per field; also the stool was positive in 98.9 per cent of patients. In addition, fecal leukocytes per field were related to some kind of enteropathogenic bacteria (p<0.001)...

Fecal indicators and bacterial pathogens in bottled water from Dhaka, Bangladesh

Forty-six bottled water samples representing 16 brands from Dhaka, Bangladesh were tested for the numbers of total coliforms, fecal indicator bacteria (i.e., thermotolerant Escherichia coli and Enterococcus spp.) and potential bacterial pathogens (i.e., Aeromonas hydrophil, Pseudomonas aeruginos, Salmonella spp., and Shigella spp.). Among the 16 brands tested, 14 (86%), ten (63%) and seven (44%) were positive for total coliforms, E. coil and Enterococcus spp., respectively. Additionally, a further nine (56%), eight (50%), six (37%), and four (25%) brands were PCR positive for A. hydrophila lip, P. aeruginosa ETA, Salmonella spp. invA, and Shigella spp. ipaH genes, respectively. The numbers of bacterial pathogens in bottled water samples ranged from 28 ± 12 to 600 ± 45 (A. hydrophila lip gene), 180 ± 40 to 900 ± 200 (Salmonella spp. invA gene), 180 ± 40 to 1,300 ± 400 (P. aeruginosa ETA gene) genomic units per L of water. Shigella spp. ipaH gene was not quantifiable. Discrepancies were observed in terms of the occurrence of fecal indicators and bacterial pathogens. No correlations were observed between fecal indicators numbers and presence/absence of A. hydrophila lip (p = 0.245), Salmonella spp. invA (p = 0.433), Shigella spp. ipaH gene (p = 0.078), and P. aeruginosa ETA (p = 0.059) genes. Our results suggest that microbiological quality of bottled waters sold in Dhaka, Bangladesh is highly variable. To protect public health, stringent quality control is recommended for the bottled water industry in Bangladesh.

The prevalence of swine enteropathogens in Brazilian grower and finish herds

Diarrhoea among growing and finishing pigs is an important problem in many herds. The prevalence of L. intracellularis, B. pilosicoli, B. hyodysenteriae, Salmonella spp., enterotoxigenic E. coli, Trichuris suis and the occurrence of mixed infection were investigated. Fecal samples for forty-six herds with diarrhea or a history of diarrhea were randomly collected in Minas Gerais state, Brazil. The enteric pathogens were detected by culture (E. coli and Salmonella sp.), PCR (L. intracellularis and Brachyspira spp.) and eggs counts (T. suis). The overall herd prevalence of L. intracellularis, Salmonella enterica serotype Typhimurium and enterotoxigenic E. coli were 19.56%, 6.52%, 10.86% respectively. Mixed infection was diagnosed in 30.43% of herds, and L. intracellularis and Salmonella enterica serotype Typhimurium are main pathogens association (10.87%). B. pilosicoli was diagnosed only in two herds, always associated with mixed infections. B. hyodysenteriae and T. suis were not demonstrated in any sample. These pathogens have been reported world-wide but studies regarding epidemiology in Brazil are few. This study contributes to establish of prevention programs for the control enteropathogens in grower finish herds in Brazil.

Epidemiologia das betalactamases de espectro estendido no Brasil: impacto clínico e implicações para o agronegócio / Epidemiology of extended-spectrum beta-lactamases in Brazil: clinical impact and implications for agribusiness

A emergência e a disseminação de bactérias produtoras de betalactamases de espectro estendido (ESBL) têm sido retratadas como grande problema de saúde pública, especialmente no que diz respeito a patógenos associados às infecções relacionadas com a assistência à saúde (IRAS). No Brasil, a maior preocupação inclui as altas taxas de resistência a Klebsiella pneumoniae e Escherichia coli, embora as ESBL estejam amplamente disseminadas entre os membros da família Enterobacteriaceae e sejam descritas como enzimas do tipo TEM, SHV, CTX-M, VEB, BES e GES em diferentes estados. Contudo, as enzimas dos grupos CTX-M-2, CTX-M-8 e CTX-M-9 são as mais prevalentes em território brasileiro. Além do ambiente hospitalar, as ESBL de origem comunitária e ambiental têm sido retratadas. A CTX-M-2 também tem sido identificada em Salmonella, oriunda do ciclo de produção animal, o que é alarmante para o Brasil diante da importância que a exportação de carnes assume para o agronegócio. Dessa forma, faz-se necessária a regulamentação do uso de antimicrobianos em todos os setores, a fim de evitar a disseminação de bactérias resistentes e resguardar a qualidade e a inocuidade dos alimentos. Portanto, o presente estudo visa retratar o panorama geral da epidemiologia das ESBL no Brasil, enfatizando o impacto clínico, ambiental e econômico.

The emergence and dissemination of extended-spectrum beta-lactamase bacteria (ESBL) have been reported as a major public health issue, mainly with regard to nosocomial infections. In Brazil, ESBL are widely disseminated among the Enterobacteriaceae family and enzymes TEM, SHV, CTX-M, VEB, BES and GES have been reported in several states. However, the major concern is the high rates of resistant Klebsiella pneumoniae and Escherichia coli strains. Currently, ESBL belonging to CTX-M-2, CTX-M-8 and CTX-M-9 subtypes are the most prevalent in Brazil. Apart from nosocomial infections, ESBL bacteria from outpatient and environmental samples have been identified. CTX-M-2 has been identified in Salmonella samples from animal production, which may have dire consequences for agribusiness, particularly meat export in Brazil. Thus, the regulation of antimicrobial agents is vital in order to avoid the dissemination of multidrug-resistant bacteria and to assure the quality and innocuousness of food products. Therefore, this review aims to report the epidemiology of ESBL in Brazil, focusing on their clinical, environmental and economic impact.

Opportunistic microorganisms in patients undergoing antibiotic therapy for pulmonary tuberculosis

Antimicrobial therapy may cause changes in the resident oral microbiota, with the increase of opportunistic pathogens. The aim of this study was to compare the prevalence of Candida, Staphylococcus, Pseudomonas and Enterobacteriaceae in the oral cavity of fifty patients undergoing antibiotic therapy for pulmonary tuberculosis and systemically healthy controls. Oral rinsing and subgingival samples were obtained, plated in Sabouraud dextrose agar with chloramphenicol, mannitol agar and MacConkey agar, and incubated for 48 h at 37ºC. Candida spp. and coagulase-positive staphylococci were identified by phenotypic tests, C. dubliniensis, by multiplex PCR, and coagulase-negative staphylococci, Enterobacteriaceae and Pseudomonas spp., by the API systems. The number of Candida spp. was significantly higher in tuberculosis patients, and C. albicans was the most prevalent specie. No significant differences in the prevalence of other microorganisms were observed. In conclusion, the antimicrobial therapy for pulmonary tuberculosis induced significant increase only in the amounts of Candida spp.

Resistencia antimicrobiana de los principales microorganismos aislados en Hospital General San Juan de Dios durante el período 2005-2010 / Antimicrobial resistance of microorganisms isolated from the main San Juan de Dios General Hospital during the period 2005-2010

La presencia de fracaso terapéutico en las infecciones por enterobacterias y cocos Gram positivo ha dirigido los estudios hacia los mecanismos de resistencia de dichos microorganismos y se ha comprobado la presencia de bacterias productoras de enzimas inactivadoras de los antibióticos betalactamicos (betalactamasas), el presente estudio se realizó transversalmente efectuando una recopilación de todos los aislamientos realizados en el laboratorio clínico, en la base de datos de MicroScan Walk Away 96, (DADE Behering), de todos los crecimientos bacterianos durante los años 2005 al 2010...

Aislamiento de enterobacterias en la mosca común (Musca domestica) en Coro, estado Falcón, Venezuela / Isolation of enterobacteria from Musca domestica in Coro, Falcon state, Venezuela

La mosca común (Musca domestica) es una especie con una amplia ubicuidad adaptada a los ambientes humanos, y que constituye un problema de salud pública en aquellas áreas rurales y urbanas con un inadecuado manejo sanitario. En un intento por aislar enterobacterias en adultos de M. domestica, entre Enero y Mayo de 2006 se han recolectado, mediante mallas entomológicas ad hoc, 30 ejemplares en tres sitios de la ciudad de Coro, estado Falcón, Venezuela: mercado municipal (N=10), Hospital Universitario “Alfredo Van Grieken” (HUAVG) (N=10) y basurero municipal (N=10). El análisis bacteriológico reveló la presencia en el 96,67% de las moscas sembradas de seis géneros y diez especies de bacterias Gram negativas de la familia Enterobacteriaceae, incluyendo: Enterobacter cloacae, E. gergoviae, E. aerogenes, Escherichia coli, Pantoea agglomerans, Proteus mirabilis, P. vulgaris, Providencia rettgeri, P. alcalifaciens y Morganella morganii. De éstas, se aislaron siete especies de enterobacterias en las moscas capturadas en los alrededores del HUAVG, y seis en el mercado y el basurero municipales. P. agglomerans (30%: 9/30), P. mirabilis (23,33%: 7/30) y E. cloacae (16,67%: 5/30) fueron las especies bacterianas más frecuentemente aisladas. Como las especies de Enterobacteriaceae detectadas en el presente trabajo en M. domestica también han sido aisladas en infecciones dérmicas, urinarias, pulmonares y gastrointestinales de humanos del HUAVG, se sugiere por lo tanto que la mosca común pudiera estar jugando un papel importante como forente en la transmisión de bacterias potencialmente patógenas para el hombre en ambientes hospitalarios, domiciliarios y establecimientos de ventas de alimentos (mercados) de la ciudad de Coro, estado Falcón, Venezuela.

The housefly (Musca domestica) is a species and is characteristically associated with human activity. Houseflies constitute a health hazard in rural and urban areas with poor sanitary facilities. Between January and May 2006, enterobacteria were isolated in 30 adults of Musca domestica captured in 3 municipal environments: an out market (N=10), a dumping ground (N=10) and a hospital (HUAVG) (N=10), from Coro city, Falcón state, Venezuela. Bacteriological analysis revealed the presence of 10 Gram negative bacterial species (Enterobacteriaceae) in 96.67% of the flies cultured, including: Enterobacter cloacae, E. gergoviae, E. aerogenes, Escherichia coli, Pantoea agglomerans, Proteus mirabilis, P. vulgaris, Providencia rettgeri, P. alcalifaciens y Morganella morganii. Of these, seven enterobacteria species were isolated from flies collected in HUAVG, and six each from those caught in market and dumping ground areas. Pantoea agglomerans (30%: 9/30), P. mirabilis (23.33%: 7/30) and E. cloacae (16.67%: 5/30) were the enterobacteria most frequently detected. The Enterobacteriaceae specie isolated here from M. domestica also has been detected in human dermal, urinary, pulmonary and gastrointestinal infections at HUAVG. Therefore, the role of the housefly as a potential mechanical vector of potentially pathogenic enterobacteria to humans in hospital, domiciliary and food supply environments from Coro city, Falcón state, Venezuela, is suggested.

Patógenos veiculados por saladas de alface servidas em restaurantes / Borne pathogens by lettuce salads served in restaurants

O objetivo deste trabalho foi avaliar a qualidade microbiológica e parasitológica de salada de alface servida em restaurantes self-services no município de Taubaté-SP. Na estação seca duas amostras (14,3 por cento) apresentaram coliformes fecais em níveis superiores ao permitido pela Vigilância Sanitária (10² NMP/g), sendo que na estação úmida seis amostras (42,9 por cento) foram positivas. A presença de Escherichia coli foi confirmada em três amostras (21,43 por cento) colhidas na estação seca e em cinco (35,7 por cento) na úmida. As enterobactérias mais freqüentes, nas duas estações, foram Enterobacter aglomerans e Klebsiella pneumoniae, respectivamente, 57,1 por cento e 50,0 por cento na seca e 71,4 por cento e 85,7 por cento, na úmida. Cryptosporidium spp. foi o parasito mais freqüente, sendo encontrado em quatro amostras (28,57 por cento) na estação úmida e em uma (7,1 por cento) na seca. Grande percentual dos restaurantes avaliados não oferecia alfaces com condições higiênicas sanitárias adequadas, sendo que a contaminação foi maior na estação úmida, podendo ser conseqüência do maior índice pluviométrico, o que torna um ambiente adequado para proliferação de patógenos, ou até mesmo pelo despreparo dos manipuladores às normas para o preparo dos alimentos.

[Study of total count, E. coli and coliforms contamination of raw milk from letdown stage till delivery to factory in Lorestan province]

The primary quality of raw milk is affected by several factors including animal nutrition, animal health, milk components, and its bacterial activity and these factors are effective on the final products. Therefore, the quality of raw milk depends on time and milk condition from production to delivery. In Lorestan, 97% of the milk production is obtained from rural and small units. This study was carried out to determine the factors affecting the bacteriological quality of raw milk from letdown phase till delivery to factory and to find out the critical points of bacterial contamination in the years 2003 and 2004. In this study, the collecting centers of raw milk with a capacity of more than 3 tons, between 1.5 to 3 tons, and fewer than 1.5 tons were included as the centers with high, moderate, and low capacity respectively. The sampling stages consisted of cow milk letdown, milk collecting equipment, milk collecting tankers, milk cooling tanks, and milk delivery to factory. Microbial experiments consisted of standard plate count [SPC], E. coli, and coliforms. All the collected samples were 45 ones in each month and 540 samples in a year. Being converted to Log 10, the data were analyzed by the SPSS software [version 11.5] and GLM procedure was used to determine the effects of month, capacity of centers, and sampling stages. Based on the results of the study, the average total count [TC] in all seasons in Lorestan province was 6.43 o 0.37 cfu/m. The effects of month, capacity of centers, and the sampling stages on TC, E. coli, and coliforms were statistically significant [p<0.01]. Additionally, the lowest TC [6.31 o 0.38 cfu/m] was in January while the highest [6.57 o 0.31 cfu/m] was in August. Moreover, the decreasing trend of TC started from September and was the lowest in January and February. Correlation coefficients showed that there was a significant positive correlation between TC and E. coli [r=0.79] and TC and coliforms [r=0.90, p<0.01]. The major problems of milk collecting in Lorestan province are the long distances of some milk collecting centers from the milk factories as well as the long milk delivery time which play important roles in increasing TC from letdown stage till delivery to factory in addition to the insufficient road facilities in some of the villages in Lorestan province

Enterobacterias productoras de beta lactamasa de espectro expandido en pacientes críticos de la Maternidad Concepción Palacios / Expanded spectrum beta lactamase producting enterobacterias in crtical patients from Maternity Hospital

Dentro de los mecanismos de resistencia bacteriana encontrados en los miembros de las Enterobacteriaceae, las Beta Lactamasas de Espectro Expandido (BLEE), juegan un papel importante ya que debido a su naturaleza plasmídica pueden diseminarse a otros géneros diferentes a E. coli, K. pneumoniae y K. oxytoca, de donde principalmente se han descrito y confieren resistencia a cefalosporinas de tercera y cuarta generación y a aztreonam. Dado que en la Maternidad “Concepción Palacios” (MCP) la mayor parte de los pacientes constituyen neonatos y el tratamiento empleado principalmente son cefalosporinas, se evaluó la frecuencia en este centro de Enterobacterias productoras de BLEE aislados en áreas críticas de muestras de hemocultivos, puntas de catéter, orina y secreciones en el período comprendido de Enero a Junio de 2006. La identificación y sensibilidad se realizaron con las galerías ID32GN y ATBGN-5 respectivamente, utilizando el equipo semiautomatizado Mini API (BioMérieux). Para la detección fenotípica de producción de BLEE se empleó el método de doble difusión con discos y el método recomendado por el Clínical and Laboratory Standard Institute (CLSI) (1). La mayor frecuencia se obtuvo para Pantoea agglomerans, seguida de Klebsiella pneumoniae, y Enterobacter cloacae. El 80 % de las enterobacterias aisladas, fueron productoras de BLEE.

Inside the mechanisms of bacterial resistance found in members of the Enterobacteriaceae family, the Expanded Spectrum Beta Lactamasas (ESBL), play an important role due to its plasmid nature it can be spread to other different genera to E. coli, K.pneumoniae, and K. oxytoca, wherefrom principally they have been described, and award resistance to cephalosporin of third and fourth generation and to aztreonam. In view of the Maternity “Concepción Palacios” (MCP) most of the patients constitutes newborn, and the principally used treatment are cephalosporin, the frequency of ESBL producting enterobacteria was evaluated in this center, isolated in critical areas from samples of blood cultures, tops of catheter, urine and secretions from January to June, 2006. The identification and sensibility were realized by the galleries ID32GN and ATBGN-5 respectively, using the semi automated Mini API (BioMérieux) equipment. For the phenotypical detection of ESBL production there were used the double diffusion of disc method and the method recommended by the Clinical and Laboratory Standard Institute (CLSI) (1). The major frequency was to Pantoea agglomerans followed by Klebsiella pneumoniae, and Enterobacter cloacae. 80% of the isolated enterobacteria, were producer of ESBL.

Genotipificación de cepas de enterobacterias procedentes de 4 centros de salud del área de Caracas / Genotyping of enterobacterias strains from 4 healthcare centers in Caracas

Las infecciones nosocomiales pueden ser producidas por microorganismos resistentes a la acción de los antimicrobianos que han sido seleccionados por la mal uso ó el uso indiscriminado de los antibióticos en el ámbito hospitalario. En los últimos años se han desarrollado nuevas técnicas moleculares de tipificación basada en la reacción en cadena de la polimerasa (PCR), que han representado un avance importante en el estudio de las enfermedades infecciosas, siendo muy útiles al permitir diferenciar serotipos estrechamente relacionados y grupos de cepas no relacionadas clonalmente, debido a su gran poder discriminatorio. En Venezuela, son pocos los estudios de eepidemiología molecular de las infecciones intrahospitalarias, y por esta razón nos propusimos genotipificar cepas de Escherichia coli y Klebsiella pneumoniae provenientes de aislados nosocomiales de cuatro centros de salud del área metropolitana (Hospital "Dr. José María Vargas", Hospital "Dr. Domingo Luciani", Centro Médico de Caracas y Policlínica Metropolitana) con la finalidad de determinar la relación clonal existente entre estas cepas. El uso de ERIC-PCR permitió relacionar parcialmente las especies de E. coli aisladas en los cuatro centros de salud, sin embargo la técnica de REP-PCR permitió discriminar entre los patrones de bandas similares, mostrando un poder de resolución mayor. El uso de ERIC-PCR y REP-PCR no permitió tipificar la mayoría de las cepas de K. pneumoniae aisladas en los cuatro centros de salud en estudio. En el Centro Médico de Caracas se identificaron dos aislados clonales provenientes de diferentes áreas del hospital, Unidad de Terapia de Adultos y Hospitalización. En la Policlínica Metropolitana se identificaron tres aislados clonales, dos en la unidad de Terapia y uno en Hospitalización. En el Hospital "Dr. Domingo Luciani" y en el Hospital "Dr. José María Vargas" no se identificaron clones. Estos resultados proporcionan un aporte a los programas de vigilancia...

Nosocomial infections can be produced by microorganisms resistand to antimicrobial agents, and they have been selected by the bad use or abuse of antibiotics in the hospital environment. Recently, new molecular typing techniques have been developed, based on polymerase chain reaction (PCR). These techniques represent an important advantage the study of infectious diseases; they are able to discriminate relate closed serovars and groups of nonrelated isolates due to its great power discriminatory. In Venezuela, there is a small number of molecular epidemiology researches. The goal of the present study is genotyping Escherichia coli and Klebsiella pneumoniae isolated of nosocomial infected patients from four healthcare centers in the metropolitan area (Hospital "Dr. José María Vargas", Hospital "Dr. Domingo Luciani", Centro Médico de Caracas, Policlínica Metropolitana) in order to investigate the clonal relationship between the isolates. ERIC-PCR allowed us to correlate E. coli isolates however REP-PCR shows greater greater resolution. The use of both ERIC-PCR and REP-PCR, did not permit us typing K. pneumoniae isolates. Two clonally related isolates from Centro Médico de Caracas were identified. Three clonally related isolates from the Policlínica Metropolitana ere identified. No clones were identified in samples from Hospital "Dr. Domingo Luciani" and the Hospital "José María Vargas". These results contribute to monitoring programs, to improve the control of the bacterial infections, helping to establish efficient procedures and reduce nosocomials infections.

Avaliação da qualidade sanitária e ocorrência de Aeromonas spp em lagoas de pesque-pague da região metropolitana de São Paulo / The evaluation of sanitary conditions and the ocurrence of the genus Aeromonas in fee-fishing ponds located in the São Paulo metropolitan region, Brazil

Introdução. As atividades de pesca esportiva, denominadas lagoas de pesque-pague, têm sido utilizadas como alternativa de lazer pela maioria das pessoas que vivem nos grandes centro urbanos. Entretanto, as condições sanitárias das águas desses estabelecimentos é uma importante questão na manutenção da saúde dos consumidores. Objetivo. Avaliar as condições sanitárias da água e a ocorrência do gênero Aeromonas em lagoas de pesque-pague localizadas na Região Metropolitana de São Paulo. Métodos. Amostras de 30 lagoas de pesca foram obtidas durante as estações seca (inverno) e chuvosa (verão), para contagem de coliformes fecais e ocorrência de bactérias patogênicas tais como Salmonella spp acima dos valores recomendados pelo Conselho Nacional do Meio Ambiente (CONAMA N°20-01/06/86) durante a estação seca e cerca de 33,3 por cento na chuvosa. O gênero Aeromonas foi observada em alta freqüência (>80 por cento) nas lagoas de pesca, durante os períodos seco e chuvoso. Em adição, uma alta diversidade de espécies de Aeromonas foi observada também nas amostras de água (61 por cento) e peixe (55,5 por cento) Conclusões. Os elevados níveis de matéria orgânica nos reservatórios observados durante a estação chuvosa contribuíram para os reservatórios observados durante a estação chuvosa contribuíram para os níveis de coliformes fecais e Aeromonasspp, além disso, a prática de manejo inadequada contribuiu para a manutenção de um qualidade da água insatisfatória. Em adição, cepas de Aeromonas spp detectadas nas amostras de água e peixe, durante ambos os períodos, apresentaram uma elevada porcentagem de plasmídios, sugerindo a ocorrência de fatores de resistência neste grupo de bactérias patogências.

Bacterial aetiology of osteomyelitis cases at four hospitals of Lahore

The conclusive diagnosis of osteomyelitis requires isolation of pathogen in aspirate from bone lesion, bone debridement and blood culture. The present research was undertaken to study the microbiological pattern of cases of osteomyelitis reporting to four hospitals in Lahore. Method: One hundred and fifty patients of osteomyelitis were selected from outpatient departments and Orthopaedic wards of Lahore General Hospital, Sir Ganga Ram Hospital, Services Hospital and Mayo Hospital, Lahore. Specimens of pus from bone, blood and bone debridement were collected. All samples were inoculated onto two Blood Agar and one MacConkey agar plates. One Blood Agar plate was incubated anaerobically for 48 hours and the other two plates aerobically for 24 hours. Smears were made from samples and stained by the Gram's stain. The colonies obtained were processed according to the technique of Mackie and MacCartney. The commonest isolates belonged to the Enterobacteriaceae [32.8%], followed by Staphylococcus aureus [29.5%], Pseudomonas aeruginosa [15.5%], anaerobes [2.6%] and miscellaneous [19.3%]. Five [2.7%] anerobic bacteria were isolated. Anaerobic bacteria were peptostreptococci, peptococci and bacteroides either alone or as a mixed infection. The present study highlights the importance of microbiological examination of bone in cases of osteomyelitis. Different types of bacteria either alone or as a mixed infection could be the causative agent[s]

MRSA Septic Polyarthritis: a case report and review of literature

A 45-year-old male patient with history of hypertension and diabetes mellitus was admitted to the hospital because of increasing erythema and swelling of left elbow, bilateral wrist, right knee and right ankle joints of two weeks duration. He had undergone amputation of his left big toe two months prior to presentation, which was complicated by wound infection and poor healing. He had been treated with multiple courses of empiric oral and intravenous antibiotics to control the local infection. On examination, the patient's temperature was 102 F, pulse rate was 90 beats per minute, and blood pressure was 160/90 mm Hg and respiratory rate 20 per minute. There was significant tenderness, swelling and erythema of both wrists. Left knee and ankle appeared markedly swollen and tender with severe limitation of movement. Left big toe wound looked infected with purulent drainage. Synovial fluid aspirate from right wrist and knee showed numerous pus cells and gram-positive cocci on Gram stain. The culture grew S. aureus resistant to methicillin but sensitive to vancomycin, teicoplanin, chloramphenicol and fusidic acid. Three consecutive blood cultures also grew colonies of S. aureus. Therefore the diagnosis of MRSA septic polyathritis was made