Resistencia plasmídica a colistin por el gen mcr-1 en Enterobacteriaceae en Paraguay / Plasmid-Mediated Colistin Resistance Gene mcr-1 in Enterobacteriaceae in Paraguay

La resistencia a las polimixinas mediada por plásmidos (gen mcr-1) representa una amenaza para la salud pública, puesto que colistina es utilizada en la práctica médica como una de las últimas alternativas para el tratamiento de gérmenes multiresistentes. Este estudio describe la circulaciónde cepas de Enterobacterias que portan este gen de resistencia, aisladas de pacientes hospitalizados, así como también de la comunidad. Los hallazgos de la Red de Vigilancia de la Resistencia a los Antimicrobianos-Paraguay fueron de casi el 5 % (4,7) en cepas remitidas con criterio de sospecha, siendo las especies involucradas Escherichiacoli, Klebsiella pneumoniae y Salmonella Schwarzengrund. Además, por métodos moleculares se confirmaron en todas ellas la portación de otros genes de resistencia (KPC, CTX-M, Qnr B, Qnr S, aac (6`)-Ib-cr) asociados al mcr-1. Palabras claves: Enterobacterias, resistencia, colistina, mcr-1.

Resistance to polymyxins mediated by plasmids (mcr-1 gene) represents a threat to public health, since colistin is used in medical practice, as one of the last alternatives, for the treatment of multi-resistant germs. This study describes the circulation of strains of Enterobacteria that carry this resistance gene, isolated from hospitalized patients, as well as from the community. The findings of the Red de Vigilancia de la Resistencia a los Antimicrobianos­Paraguay were almost 5% (4.7) in strains submitted with suspicion criteria; the species involved being Escherichia coli, Klebsiella pneumoniae and Salmonella Schwarzengrund. In addition, molecular methods confirmed in all of them the carrying of other resistance genes (KPC, CTX-M, Qnr B, Qnr S, aac (6`)-Ib-cr) associated with mcr-1. Key words: Enterobacteria, resistance, colistin, mcr-1.

effects of berberine and palmatine on efflux pumps inhibition with different gene patterns in Pseudomonas aeruginosa isolated from burn infections

Background: Related Multidrug Resistance [MDR] to efflux pumps is a significant problem in treating infections caused by Pseudomonas aeruginosa [P. aeruginosa]. Plant compounds have been identified as Pump Inhibitors [EPIs]. In the current study, the potential effect of Berberine and Palmatine as EPIs were investigated on efflux pump inhibition through focusing on different gene patterns in P. aeruginosa isolated from burn infections

Methods: All isolates were collected and identified using the standard biochemical tests. Antimicrobial sensitivity was performed based on disk agar diffusion method for 12 antibiotics. MIC-MBC tests were also performed based on the broth microdilution method to detect synergistic relationship between ciprofloxacin, Berberine and Palmatine. Detection of mexA, mexB, mexC, mexD, mexE, mexF and mexX was conducted by PCR assay. Fisher's Exact test and Logistic Regression were used as statistical tools

Results: A total of 60 P. aeruginosa isolates were collected. The highest and lowest levels of resistance were found to be respectively against clindamycin and tigecycline. Comparing the MIC with MBC distribution, it was found that Berberine and Palmatine lower the MIC-MBC level of ciprofloxacin. The PCR results indicated that the highest frequency is about MexAB-OprM operon. The statistical analysis among different gene patterns of efflux pumps showed that there were no significant relationships between the effectiveness of Berberine and Palmatine [p>0.05]

Conclusion: It can be speculated that Berberine and Palmatine both act as EPIs and can be used as auxiliary treatments with the purpose of increasing the effect of available antibiotics as well as decreasing the emergence of MDR bacteria. The efficiency of these combinations should be studied further under in vivo conditions to have a more comprehensive conclusion regarding this issue

Expresión del gen asociado con la resistencia múltiple a medicamentos (pfmdr1) en cepas colombianas de Plasmodium falciparum / Expresion of the multiple drug resistance associated gene (pfMDR 1) in Colombian strains of Plasmodium falciparum

El tratamiento y control de la malaria ha sido obstaculizado por la capacidad del parásito para desarrollar resistencia a agentes antimaláricos. La cloroquina, que ha sido el principal agente antimalárico debido a su eficiencia, baja toxicidad y costo, ahora frecuentemente fracasa en el control de la enfermedad. El mecanismo por el cual los parásitos desarrollan resistencia a cloroquina no se ha establecido hasta el momento, aunque inicialmente la amplificación, sobre-expresión y mutaciones puntuales en un gen denominado pfmdr1 (Plasmodium falciparum multidrug resistant gene) fueron asociadas con el fenotipo cloroquinorresistente (CQR); estudios posteriores suscitaron controversia acerca de esta asociación. En el trabajo se estudió la expresión del gen pfmdr1 en las cepas colombianas de P. falciparum y en dos cepas de referencia, una sensible (Haití 135) y una resistente (Palo Alto), mediante un ensayo de slot-blot. Los resultados obtenidos permiten sugerir que la expresión del gen pfmdr1 no está directamente relacionada con el fenotipo resistente