Increasing prevalence and dissemination of invasive nontyphoidal Salmonella serotype Typhimurium with multidrug resistance in hospitalized patients from southern Brazil

ABSTRACT Introduction: Nontyphoidal Salmonella serotypes are the main cause of human food-borne infection, including several hospitalization cases in the developing countries. Aim: To detect the main serotypes and to characterize the antibiotic resistance of human non-enteric and enteric nontyphoidal Salmonella from clinical isolates in Brazil. Methods: Salmonella serotypes were identified by microbiological and molecular methods. Susceptibility testing to antibiotics was performed by agar disk diffusion. Real-time PCRs were carried out for the detection of the genus Salmonella as well as serotypes Typhimurium and Enteritidis. Results: A total of 307 nontyphoidal Salmonella were isolated from 289 different patients in a reference laboratory (LACEN-RS) from Southern Brazil in a six-year period (2010-2015). There were 45 isolates from emerging cases and 244 from sporadic cases in hospitalized patients. Non-enteric isolates were detected in 42.6% of the patients from sources such as urine, blood and other clinical fluids. Serological and PCR-specific tests demonstrated that Typhimurium (48.4%) and Enteritidis (18.3%) were the most frequent serotypes. Typhimurium isolates were generally resistant to three or more antibiotic classes, while Enteritidis isolates to one or two classes. Typhimurium was the most frequent serotype in all samples (48.4%), mainly among the hospitalized patients (55.6%), and presented the highest rates of multidrug resistance (59.3% of the isolates of this serotype). Further, the prevalence of this serotype increased along the years of the study in comparison to other nontyphoidal Salmonella serotypes. Conclusion: Greater public health attention should be given to prevent salmonellosis in the community and in hospital settings to reduce the rates of Typhimurium strains with multidrug resistance.

Un quinquenio de experiencia (2005-2010) con infecciones por Salmonella spp en un centro nacional de referencia en pediatría / A five-year experience with zoonotic Salmonella at a pediatric reference centre

Resumen Introducción: Salmonella sp puede causar infecciones asintomáticas, gastroenteritis, bacteriemia e infecciones focales como meningitis y osteomielitis. Objetivo: Describir aspectos microbiológicos y clínicos de las infecciones por Salmonella spp en niños en un hospital de referencia pediátrico Centro Hospitalario Pereira Rossell. Montevideo Uruguay. Material y Métodos: Estudio descriptivo y retrospectivo de pacientes en quienes se aislara Salmonella spp en el período 1 de enero de 2005 al 31 de diciembre de 2010. Resultados: Se aisló Salmonella spp en 46 niños menores de 15 años. Dieciocho eran menores de 2 años y 5 niños menores de tres meses. 24% de los pacientes presentaba factores de riesgo (infección por VIH; enfermedad hemato-oncológica, desnutrición) y co-morbilidades (bajo peso al nacer y neumonía). No hubo fallecidos. Los serotipos más frecuentes fueron: Typhimurium y Enteritidis. La mayoría de las cepas eran sensibles a ampicilina y cefalosporinas de tercera generación. Discusión: La presentación clínica predominante fue diarrea con sangre, no se presentaron brotes. Basados en los perfiles de susceptibilidad antimicrobiana, se pueden mantener las recomendaciones hasta el momento sugeridas. Conclusiones: Se debe tener en cuenta la infección por Salmonella sp en niños febriles con riesgo de enfermedad bacteriana invasora, con o sin focalidad.

Background: Salmonella can cause asymptomatic infections, diarrhea, bacteremia and focal infections such as meningitis and osteomyelitis. Aim: To describe clinical and microbiological aspects of infections by Salmonella spp. in children in a pediatric referral hospital: Centro Hospitalario Pereira Rossell, in Montevideo, Uruguay. Materials and Methods: Descriptive and retrospective study of 46 patients, from which Salmonella spp was isolated between January 1, 2005 and December 31, 2010. Results: Salmonella spp was isolated in 46 children younger than 15 years old. 18 were below 2 years old and 5 children below three months. 24% of the children had risk factors, such as HIV infection, oncological diseases and malnutrition; low birth weight and pneumonia were associated conditions. No deaths were reported. The serotypes more frequently found were: Typhimurium and Enteritidis. Most of the strains were susceptible to ampicillin and third generation of cephalosporins. Discussion: Diarrhea with blood was the predominant clinical presentation, and there were no outbreaks. Typhimurium and Enteritidis were the most common serotypes. Based on the profiles of susceptibility antimicrobial, we could maintain the same recommendations until the moment suggested. Conclusions: we must consider the Salmonella infection in febrile children under risk of an invasive bacterial disease, with or without focal infection.

Effect of rosemary essential oil and modified-atmosphere packaging (MAP) on meat quality and survival of pathogens in poultry fillets

The effect of rosemary (Rosmarinus officinalis L.) essential oil (REO) and modified-atmosphere packaging (MAP) on the survival of certain pathogens (Salmonella Typhimurium and Listeria monocytogenes) in poultry fillets and on their meat quality during 7 days of refrigerated storage were investigated. Because REO at 0.05% and 0.1% had weak antibacterial activity and REO at 0.3%, 0.5% and 1.0% imparted unacceptable organoleptic properties, only REO at 0.2% was used to treat the poultry meat. The results showed that adding 0.2% REO to poultry fillets did not reduce the size of the population of S. Typhimurium and L. monocytogenes. However, REO treatment significantly decreased the L* (lightness) value and increased the a* (redness) value of stored fillets, and adding REO in combination with MAP reduced the level of lipid oxidation. In conclusion, in a suitable combination, REO can be applied to improve the quality of meat, but further studies should be conducted to determine the appropriate commercial level for different meat products.

Diagnóstico de un brote de Salmonella Typhimurium en Chinchillas (Chinchilla lanigera) mediante la electroforesis en gel de campo pulsado / Diagnosis of an autbreak of Salmonella Typhimurium in chinchillas (Chinchilla lanigera) by pulsed-fiel gel electrophoresis

Empleando estudios anatomopatológicos y microbiológicos se examinó a un grupo de chinchillas (Chinchilla lanigera) adultas que murieron súbitamente en 2012 en una granja de la ciudad de La Plata (Buenos Aires, Argentina). Se aisló Salmonella enterica serovar Typhimurium (S. Typhimurium) del hígado, el bazo, el corazón, los pulmones, los riñones y los intestinos de los cinco animales evaluados. Los cinco aislamientos estudiados (uno por animal) fueron sensibles a ampicilina, cefalotina, cefotaxima, ácido nalidíxico, gentamicina, estreptomicina, cloranfenicol, fosfomicina, nitrofurantoína y trimetoprima-sulfametoxazol, y resistentes a tetraciclina. El análisis de dichos aislamientos por electroforesis en gel de campo pulsado [pulsed-field gel electrophoresis (PFGE)] con XbaI mostró un perfil electroforético idéntico con 15 bandas, idéntico a su vez al patrón ARJPXX01.0220 del banco nacional argentino de datos de PulseNet, que cuenta con patrones de PFGE de Salmonella. El presente trabajo describe por primera vez el diagnóstico postmortem de un brote de salmonelosis en chinchillas usando un método molecular, como la electroforesis en gel en campo pulsado

Adult chinchillas (Chinchilla lanigera) that had suddenly died in a commercial farm located in La Plata City, Buenos Aires Province, Argentina, in July 2012 were macroscopically, histopathologically, and microbiologically examined. Salmonella enterica serovar Typhimurium (S. Typhimurium) was isolated from the liver, spleen, heart, lungs, kidneys and intestines from each of the five animals evaluated. The five strains were susceptible to ampicillin, cephalotin, cefotaxime, nalidixic acid, gentamicin, streptomycin, chloramphenicol, fosfomycin, nitrofurantoin and trimethoprimsulfamethoxazole, and resistant to tetracycline. Each of the five S. Typhimurium isolates was analyzed by XbaI- pulsed-field gel electrophoresis (PFGE), showing an identical electrophoretic profile with 15 defined bands, which was found to be identical to pattern ARJPXX01.0220 of the PulseNet Argentine National database of Salmonella PFGE patterns. This is the first work describing the postmortem diagnosis of an outbreak of salmonellosis in chinchillas by using molecular methods such as PFGE

A Lactobacillus rhamnosus strain induces protection in different sites after Salmonella enterica subsp. enterica serovar Typhimurium challenge in gnotobiotic and conventional mice / Uma cepa de Lactobacillus rhamnosus induz proteção em diferentes sítios em camundongos gnotobióticos e convencionais após desafio com Salmonella enterica subsp. enterica sorovar Typhimurium

The ability of a Lactobacillus rhamnosus strain isolated from a healthy breast-fed human newborn to reduce the pathological consequences for the host due to an experimental oral infection with Salmonella enterica subsp. enterica serov. Typhimurium in vivo was determined using gnotobiotic and conventional mice. Conventional mice received 0.1mL probiotic milk (8.0 log colony-forming unit) daily for 10 days before the oral pathogenic challenge (5.0 log colony-forming unit). Then probiotic treatment was continued until the end of the experiment. Probiotic treatment in germ-free mice consisted of a single dose of the probiotic milk at the beginning of the experiment and a challenge with S. Typhimurium 10 days later (3.0 log colony-forming unit). A protective effect was observed in both gnotobiotic and conventional animals in terms of histopathologic and morphometric data, but in different anatomical sites. This protection was observed in liver and intestines, respectively, for gnotobiotic and conventional mice. However, S. Typhimurium populations were similar in the feces of both treated and control gnotobiotic mice. We conclude that a protective effect of L. rhamnosus against experimental S. Typhimurium was observed. This protection was not due to the reduction of the population of pathogenic bacteria in the intestine...

A habilidade de uma cepa de Lactobacillus rhamnosus isolada de um recém-nascido saudável de reduzir as consequências patológicas para o hospedeiro após infecção experimental por Salmonella enterica subsp. enterica sorov. Typhimurium foi avaliada em camundongos gnotobióticos e convencionais. Os camundongos convencionais receberam 0,1mL de leite probiótico por dia (0,8 log unidade formadora de colônia), 10 dias antes do desafio oral com S. Typhimurium (5,0 log unidade formadora de colônia), e continuaram recebendo probiótico até o término do experimento. O tratamento com probiótico nos camundongos gnotobióticos consistiu em uma única dose de leite probiótico no início do experimento e desafio oral após 10 dias (3,0 log unidade formadora de colônia). Em termos histopatológicos e morfométricos, a proteção foi observada no fígado e nos intestinos nos animais gnotobióticos e convencionais, respectivamente. No entanto, a população de S. Typhimurium foi similar em ambos os grupos tratado e controle de animais gnotobióticos. Desta forma, conclui-se que a proteção conferida pela cepa de L. rhamnosus contra o desafio experimental S. Typhimurium foi observada em diferentes sítios anatômicos nos animais convencionais e gnotobióticos e que essa proteção não foi devido à redução da população de S. Typhimurium nos intestinos...

Seleção, caracterização e clonagem dos genes fljB e groEL agonistas dos receptores de reconhecimento de padrão do sistema imune inato das aves / Selection, characterization and cloning of the fljB and groEL genes agonists of the innate immune system pattern recognition receptors of birds

The recombinant production of innate immune system pattern recognition receptor agonists has provided a new tool for the production of immunostimulants for animals. The molecular pattern associated with the pathogen (PAMP), flagellin, coded by the fljB gene from Salmonella Typhimirium, and the molecular pattern associated to the damage (DAMP), HSP60, coded by the groEL gene from S. Typhimurium and S. Enteritidis, are recognized by pattern recognition receptors (PRRs) of the innate immune system of birds. In the present study, we performed the cloning of genetic fragments of the genes fljB, from S. Typhimurium, and groEL from S. Typhimurium and S. Enteritidis inserted in expression vector pET100/D-TOPO and transformed in E. coli TO10 cells. The clones were evaluated by colony PCR, plasmidial DNA PCR and genome sequencing in order to confirm the presence of these genes. In the colony PCR, we identified the presence of genes groEL (S. Enteritidis), groEL (S. Typhimurium) and fljB (S. Typhimurium) in 80%, 60% and 80% of the transformed colonies, respectively. The cloning system adopted allowed the production of HSP60 genetic fragment clones and flagellin of Salmonella strains, allowing the posterior use of these clones in gene expression trials, with the future potential of being used as non-specific immunostimulants for birds.

A produção recombinante de agonistas dos receptores do reconhecimento de padrão do sistema imune inato tem fornecido uma nova ferramenta para a produção de imunoestimulantes para animais. O padrão molecular associado ao patógeno (PAMP), flagelina, codificado pelo gene fljB de Salmonella Typhimurium e o padrão molecular associado ao dano (DAMP) HSP60, codificado pelo gene groEL da S. Typhimurium e S. Enteritidis, são reconhecidos por receptores de reconhecimento de padrões (RRPs) do sistema imune inato das aves. No presente estudo, foi feita a clonagem de fragmentos genéticos dos genes fljB de S. Typhimurium e groEL de S. Typhimurium e S. Enteritidis inseridos no vetor de expressão pET100/D-TOPO e transformados em células de E. coli TOP10. Os clones foram avaliados pela PCR de colônia, PCR de DNA plasmidial e sequenciamento genômico para a confirmação da presença desses genes. Na PCR de colônia, foram identificadas em 80%, 60% e 80% das colônias transformadas, a presença dos genes groEL (S. Enteritidis), groEL (S. Typhimurium) e fljB (S. Typhimurium) respectivamente. O sistema de clonagem adotado possibilitou a produção de clones dos fragmentos genéticos da HSP60 e flagelina das cepas de Salmonella, permitindo a utilização posterior desses clones em ensaios de expressão gênica, com potencial futuro de serem utilizados como imunoestimulante inespecífico das aves.

Induction of immune response in broiler chickens immunized with recombinant FliC and challenged by Salmonella Typhimurium / Indução de resposta imune em frangos de corte imunizados com FliC recombinante e desafiados por Salmonella Typhimurium

The study examined (1) the immune response in broiler chickens after oral immunization with recombinant flagellin (rFliC) from Salmonella Typhimurium conjugated with sodium alginate microparticles, and the immune response enhancement in association with recombinant cholera toxin B subunit protein (rCTB) and pool of Lactobacillus spp. (PL). The immune responses were evaluated by dosage of IgY serum and IgA from intestinal fluid and immunostaining of CD8+ T lymphocytes in the cecum. The immunized animals were challenged with Salmonella Typhimurium (ST) 21 days after treatment. In all immunized groups, a significant increase (p<0.05) was observed in IgA levels (μg/mL), especially three weeks after immunization. The serum IgY levels (μg/mL) were little affected by the treatments and differed significantly among groups only in the second post-immunization week (p<0.05). After the challenge, the number of CD8+ T cells differed significantly between the treatments and negative control. Retrieval of Salmonella Typhimurium was not detected at 48 hours after the challenge in T2 (rFliC+rCTb), T3 (rFliC+PL) and T4 (rFliC+rCTB PL). The rFliC administered orally with or without rCTB and Lactobacillus spp. produces significant induction of humoral immune response, and the immunized chickens were more effective in eliminating Salmonella after challenge.

Este estudo investigou a resposta imunitária de frangos de corte após a imunização oral com flagelina recombinante (rFliC) de Salmonella Typhimurium conjugada com micropartículas de alginato de sódio, e como intensificador de resposta imune foi associada a proteína subunidade B da toxina colérica (rCTB) e pool de Lactobacillus spp. (PL). As respostas imunes foram avaliadas por dosagem de IgY sérica e IgA do fluído intestinal e imunomarcação de linfócitos T CD8+ presentes no ceco. Os animais imunizados foram desafiados aos 21 dias após tratamento com Salmonella Typhimurium (ST). Foi observado em todos os grupos imunizados um aumento significativo (p<0,05) nos níveis de IgA (μg/mL) principalmente três semanas após as imunizações. Os níveis de IgY sérica (μg/mL) foram pouco influenciados pelos tratamentos, apenas na segunda semana após imunização observou-se diferenças significativas (p<0,05) entre os grupos. Observou-se que o número de linfócitos T CD8+ apresentou diferença significativa entre os tratamentos e o controle negativo após o desafio. Quanto a recuperação de Salmonella Typhimurium, observou-se que 48 horas após o desafio já não havia detecção do agente nos grupos T2 (rFliC+rCTb), T3 (rFliC+PL) e T4 (rFliC+rCTB+PL). Concluí-se que rFliC administrada, via oral, associada ou não a Lactobacillus spp e rCTB, demonstrou induzir significativamente a resposta imune humoral e que as aves imunizadas foram mais eficientes na eliminação de Salmonella após desafio.

Detection of Salmonella spp, Salmonella Enteritidis and Typhimurium in naturally infected broiler chickens by a multiplex PCR-based assay

The presence of Salmonella in the intestinal tract, on the chickens skin and among their feathers, may cause carcasses contamination during slaughtering and processing and possibly it is responsible by the introduction of this microorganism in the slaughterhouses. A rapid method to identify and monitor Salmonella and their sorovars in farm is becoming necessary. A pre-enriched multiplex polymerase chain reaction (m-PCR) assay employing specific primers was developed and used to detect Salmonella at the genus level and to identify the Salmonella enterica serovar Enteritidis (S. Enteritidis) and Salmonella enterica serovar Typhimurium (S. Typhimurium) in broiler chicken swab samples. The method was validated by testing DNA extract from 90 fresh culture cloacal swab samples from poultry chicken cultured in phosphate buffer peptone water at 37 ºC for 18 h. The final results showed the presence of Salmonella spp. in 25% of samples, S. Enteritidis was present in 12% of the Salmonella-positive samples and S. Typhimurium in 3% of the samples. The m-PCR assay developed in this study is a specific and rapid alternative method for the identification of Salmonella spp. and allowed the observation of specific serovar contamination in the field conditions within the locations where these chickens are typically raised.

Requirement for cobalamin by Salmonella enterica serovars Typhimurium, Pullorum, Gallinarum and Enteritidis during infection in chickens

Salmonella enterica serovar Typhimurium synthesizes cobalamin (vitamin B12) only during anaerobiosis. Two percent of the S. Typhimurium genome is devoted to the synthesis and uptake of vitamin B12 and to B12-dependent reactions. To understand the requirement for cobalamin synthesis better, we constructed mutants of Salmonella serovars Enteritidis and Pullorum that are double-defective in cobalamin biosynthesis (ÃcobSÃcbiA). We compared the virulence of these mutants to that of their respective wild type strains and found no impairment in their ability to cause disease in chickens. We then assessed B12 production in these mutants and their respective wild type strains, as well as in S. Typhimurium ÃcobSÃcbiA, Salmonella Gallinarum ÃcobSÃcbiA, and their respective wild type strains. None of the mutants was able to produce detectable B12. B12 was detectable in S. Enteritidis, S. Pullorum and S. Typhimurium wild type strains but not in S. Gallinarum. In conclusion, the production of vitamin B12 in vitro differed across the tested Salmonella serotypes and the deletion of the cbiA and cobS genes resulted in different levels of alteration in the host parasite interaction according to Salmonella serotype tested.

Prevalence and antimicrobial resistance of Salmonella in chicken carcasses at retail in 15 Brazilian cities / Prevalencia y resistencia a los antimicrobianos de Salmonella en polloscongelados de venta al por menor en 15 ciudades del Brasil

Objetivo. Describir la prevalencia y la resistencia a los antibióticos de Salmonella spp. en canales de pollo congeladas de venta al por menor en 15 ciudades del Brasil. Métodos. Entre septiembre del 2004 y julio del 2006 se llevó a cabo un estudio descriptivo de los datos del Programa Nacional Brasileño de Vigilancia de la Prevalenciade la Resistencia Bacteriana en el Pollo (PREBAF). Durante el programa serecolectaron canales de pollo en 15 capitales estatales del Brasil, en las cinco regiones geográficas del país. Para aislar Salmonella spp. e identificar los serotipos, se usaron las técnicas convencionales. Para evaluar la resistencia frente a 18 antibióticos, se usó el método de la concentración inhibitoria mínima. Resultados. En las 2 679 canales de pollo examinadas, la prevalencia de Salmonella spp. fue de 2,7% (amplitud, 0,0%–8,9%). El 50,6% de las muestras positivas provinieron del estado de São Paulo. Se identificaron 18 serotipos. Los más frecuentes fueron Salmonella Enteritidis (48,8%), Salmonella Infantis (7,6%), Salmonella Typhimurium (7,2%) y Salmonella Heidelberg (6,4%). Las 250 cepas evaluadas fueron resistentes auno o más antibióticos, y 133 (53,2%) fueron multirresistentes (≥ 3 clases de antibióticos). Salmonella Heidelberg fue resistente a la ceftriaxona (75,0%) y al ceftiofur (43,8%). Conclusiones. La prevalencia de Salmonella spp. en este estudio fue relativamente baja. Sin embargo, hubo una proporción elevada de cepas multirresistentes, inclusivea las cefalosporinas de tercera generación usadas para tratar la salmonelosis invasora. Los resultados confirman la relevancia del programa PREBAF, el cual se recomienda mejorar, por ejemplo, mediante un análisis oportuno de los datos. También es necesario revisar los límites permitidos de Salmonella spp. en el pollo que se vende al por menor en el Brasil.

Objective. To describe the prevalence and antimicrobial resistance of Salmonella spp. in frozen chicken carcasses at retail from 15 Brazilian cities. Methods. A descriptive study of data from the Brazilian National Program for Monitoring the Prevalence of Bacterial Resistance in Chicken (PREBAF) was conducted from September 2004 to July 2006. The program collected chicken carcasses in 15 state capitals of Brazil inthe five geographic regions of the country. Standardized methodologies were used to isolate Salmonella spp. and identify serotypes. The minimal inhibitory concentration method wasused to test resistance to 18 antimicrobials. Results. In 2 679 carcasses examined, the prevalence of Salmonella spp. was 2.7% (range0.0%–8.9%). São Paulo State produced 50.6% of positive samples. Eighteen serotypes were identified. The most frequently occurring were Salmonella Enteritidis (48.8%), Salmonella Infantis (7.6%), Salmonella Typhimurium (7.2%), and Salmonella Heidelberg (6.4%). All 250 strains tested were resistant to one or more antibiotics, and 133 (53.2%) were multidrug resistant (≥ 3 classes). S. Heidelberg was resistant to ceftriaxone (75.0%) and to ceftiofur (43.8%).Conclusions. The prevalence of Salmonella spp. found in this study was relatively low. However, there were a high proportion of multidrug-resistant strains, including thirdgenerationcephalosporins used to treat invasive salmonellosis. The results confirm the relevance of the PREBAF program. It is recommended that PREBAF be improved, including a timely data analysis. A review of permitted limits for Salmonella spp. in retail chicken in Brazil is also needed.

Serovariedades y patrones de susceptibilidad a los antimicrobianos de cepas de Salmonella aisladas de alimentos en Cuba / Serotypes and antimicrobial susceptibility patterns of Salmonella strains isolated from food in Cuba

The serotypes of 178 isolates of Salmonella enterica taken from food in different regions of Cuba between January 2008 and December 2009 were identified, and the antimicrobial susceptibility pattern of 100 selected isolates was determined by stratasampling. A total of 20 Salmonella serotypes were identified, with a predominance of S. Enteritidis (23%), S. Agona (13.5%), and S. London (11.2%). Of all the strains, 75%were resistant or presented intermediate resistance to at least one of the drugs tested, in the following order: tetracycline (70.7%), ampicillin (22.7%), and nalidixic acid (14.7%). Ten different resistance patterns were identified. The most frequent patternscorresponded to strains that were either drug-resistant or had intermediate resistance (89.3%). Three strains (identified as S. Infantis, S. Derby, and S. Enteritidis) were multiresistant, and one of them, S. Enteritidis, was not sensitive to either nalidixic acid or ciprofloxacin. To control salmonellosis, the importance of maximizing integrated health surveillance is emphasized.

Se describen los serotipos de 178 cepas de Salmonella enterica aisladas de alimentos en diferentes regiones de Cuba entre enero de 2008 y diciembre de 2009, y el patrón de susceptibilidada los antimicrobianos de 100 aislados seleccionados mediante muestreo por estratos. Se identificaron 20 serovariedades de Salmonella entre las que predominaron S. Enteritidis (23%);S. Agona (13,5%) y S. London (11,2%). Del total, 75% de las cepas fueron resistentes o presentaronresistencia intermedia a al menos uno de los fármacos probados, en el siguiente orden, según su frecuencia: tetraciclina (70,7%); ampicilina (22,7%) y ácido nalidíxico (14,7%). Seidentificaron 10 patrones de resistencia diferentes y predominaron las cepas resistentes o con resistencia intermedia a un fármaco (89,3%). Tres cepas (S. Infantis, S. Derby y S. Enteritidis)fueron multirresistentes y una, de S. Enteritidis, dio un resultado no sensible al ácido nalidíxico y la ciprofloxacina. Se destaca la necesidad de extremar la vigilancia sanitaria integrada en el país para el control de la salmonelosis.

Tumor cervical por Salmonella Typhimurium como forma de presentación clínica de SIDA en un paciente con infección por VIH / Cervical mass caused by Salmonella Typhimurium as a clinical presentation of AIDS in a HIV-positive patient

Infections due to non-typhi salmonellae (NTS) generally cause a mild and self-limited gastrointestinal disease. However, there have been reports of atypical and severe presentations in immunocompromised patients. We report the case of a male patient who consulted with a cervical mass. He was found to be HIV-positive and Salmonella Typhimurium was isolated in one blood culture and cervical mass tissue culture. We discuss the relevance of infections by NTS in immunodeficient patients because they present with more severe illness than normal population. We emphasize the importance of NTS bacteremia as a marker of underlying immunodeficiency. We present some localized infection sites reported in the literature and their relation with particular diseases. We discuss the future relevance that an early start of antiretroviral therapy (ART) may have in HIV patients with NTS acute bacteremia or focal infections. Because infections by NTS can be severe and highly lethal they must be considered in the differential diagnosis of causative organisms of localized infections and bacteremia in HIV patients.

Las infecciones por Salmonella no-Typhi (SNT) en general se tratan de cuadros gastrointestinales benignos y autolimitados en pacientes sin patología de base. Sin embargo, se han descrito presentaciones atípicas y más graves en pacientes con algún grado de compromiso inmunológico. Presentamos el caso de un paciente de sexo masculino el cual consultó por un tumor cervical de gran tamaño. Se diagnosticó infección por VIH y se aisló Salmonella Typhimurium en un hemocultivo y en un cultivo de tejido de masa cervical. Discutimos la importancia de las infecciones por Salmonella no Typhi en el grupo de pacientes con inmunosupresión debido a que presentan cuadros más graves que la población normal. Destacamos la importancia de la bacteriemia por Salmonella no Typhi como marcadoras de inmunosupresión subyacente. Presentamos algunos sitios de infección focal reportados en la literatura médica y su relación con algunas enfermedades particulares. Nos referimos a la importancia que podría tener en el futuro el inicio precoz de terapia anti-retroviral en pacientes con infección por VIH cursando bacteriemias o infecciones focales por Salmonella no Typhi. Debido a la gravedad y alta mortalidad que pueden presentar las infecciones por Salmonella no Typhi deben considerarse dentro del diagnóstico diferencial de microorganismos causantes de lesiones focales y bacteriemia en pacientes con infección por VIH.

Prevalence of R-type ACSSuT in strains of Salmonella serovar Typhimurium DT193 isolated from human infections in Brazil / Prevalencia de resistencia de tipo ACSSuT en cepas de Salmonella serovariedad Typhimurium DT193 aisladas a partir de infecciones humanas en el Brasil

OBJECTIVE: To determine the prevalence of resistance to ampicillin, chloramphenicol, streptomycin, sulphonamides, and tetracyclines (ACSSuT) in Salmonella serovar Typhimurium definitive [phage] type (DT) 193 strains isolated from human sources over the last four decades. METHODS: From 2008 to 2010, 553 DT193 isolates out of 810 human-origin Salmonella ser. Typhimurium phage-typed strains isolated from the 1970s through 2008 were selected and tested for ACSSuT resistance: 91 strains isolated during the 1970s, 65 from the 1980s, 70 from the 1990s, and 327 from 2000-2008. Resistance profiles were determined using the disk diffusion method. RESULTS: †An antimicrobial susceptibility assay indicated 20.9 percent, or 116, of all isolates tested were ACSSuT-resistant, 52.0 percent (287) were resistant to one or more drugs in the ACSSuT profile, and 27.1 percent (150) were nonresistant (susceptible to antimicrobials). Based on the assay, overall antimicrobial resistance was extremely high in the 1970s (affecting 99.0 percent of isolates from that period) and remained high during the 1980s, when 95.4 percent of isolates had some type of antimicrobial resistance and incidence of Salmonella ser. Typhimurium DT193 R-type ACSSuT increased to 73.8 percent. R-type ACSSuT dropped to 27.1 percent (19 isolates) during the 1990s, and to 5.2 percent (17) during 2000-2008, despite a substantial increase in the number of isolates tested (397 versus 204, 111, and 98, respectively, for the previous three decades). CONCLUSIONS: †Although prevalence of Salmonella ser. Typhimurium DT193 R-type ACSSuT in Brazil has decreased since the 1970s, ACSSuT resistance markers continue to circulate. Therefore, continuous surveillance should be conducted to evaluate the occurrence of Salmonella ser. Typhimurium DT193 and its antimicrobial resistance.

OBJETIVO: Determinar la prevalencia de resistencia a la ampicilina, el cloranfenicol, la estreptomicina, las sulfonamidas y las tetraciclinas (ACSSuT) en cepas de Salmonella serovariedad Typhimurium fagotipo definitivo (DT) 193 aisladas de fuentes de origen humano durante las cuatro últimas décadas. MÉTODOS: Entre el 2008 y el 2010 se seleccionaron 553 aislados de DT193 entre 810 cepas de Salmonella serovariedad Typhimurium fagotipificadas aisladas desde la década de 1970 hasta el 2008, y en ellos se analizó la resistencia a ACSSuT: se estudiaron 91 cepas aisladas durante la década de 1970, 65 aisladas durante la década de 1980, 70 aisladas durante la década de 1990, y 327 aisladas entre el 2000 y el 2008, respectivamente. Los perfiles de resistencia a los antibióticos se determinaron mediante el método de difusión en disco. RESULTADOS: El antibiograma indicó que 20,9 por ciento (116) de todos los aislados que se analizaron fueron resistentes a ACSSuT, 52,0 por ciento (287) fueron resistentes a uno o más antibióticos del grupo ACSSuT y 27,1 por ciento (150) no fueron resistentes (es decir, fueron sensibles a dichos antibióticos). Según el análisis, la resistencia general a los antibióticos fue muy alta en la década de 1970 (y comprendió a 99,0 por ciento de los aislados de ese período) y continuó siendo alta durante la década de 1980, cuando 95,4 por ciento de los aislados presentó algún tipo de resistencia a los antibióticos y la incidencia de Salmonella serovariedad Typhimurium DT193 con resistencia de tipo ACSSuT aumentó hasta 73,8 por ciento. La resistencia de tipo ACSSuT descendió a 27,1 por ciento (31 aislados) durante la década de 1990, y a 5,2 por ciento (17 aislados) entre el 2000 y el 2008, a pesar del aumento importante en el número de aislados que se evaluaron (397 frente a 204, 111 y 98 en las tres décadas anteriores, respectivamente). CONCLUSIONES: Aunque la prevalencia de Salmonella serovariedad Typhimurium DT193 con resistencia de tipo ACSSuT en el Brasil ha disminuido desde la década de 1970, los marcadores de resistencia a ACSSuT continúan en circulación. Por consiguiente, debe llevarse a cabo una vigilancia permanente para evaluar la aparición de infecciones por Salmonella serovariedad Typhimurium DT193 y su resistencia a los antibióticos.

Salmonella typhimurium em linfonodos mesentéricos de ovinos ao abate / Presence of Salmonella typhimurium in ovine mesenteric lymph nodes at slaughter

O rebanho de ovinos no Brasil está estimado em mais de 16 milhões de cabeças. Embora o consumo da carne desta espécie ainda seja pequeno, comparado ao de outros países, o consumo de carne, inclusive ovina, tem sido associado às doenças transmitidas por alimentos, em especial a salmonelose. No presente estudo, investigou-se a ocorrência de salmonelas em linfonodos mesentéricos e conteúdo intestinal de 175 ovinos ao abate. "Pools" constituído por cinco amostras de contéudo fecal ou 5 amostras de linfonodos de 25 g foram pre-enriquecidos em 250 mL de água peptonada tamponada e incubados a 37° C por 18-24 horas. Uma alíquota de 0,1 mL do préenriquecimento foi transferida para 9,9 mL de caldo de enriquecimento Rappaport-Vassiliadis e 1,0 mL do pré-enriquecimento foi transferido para 10 mL de caldo tetrationato Muller-Kaufmann, incubados a 42° C for 24h. 10 µL do caldo de enriquecimento foi semeado superfície de placas de ágar BPLS e ágar XLT4 incubadas a 37º C for 24-48h. Colônias suspeitas de salmonela foram testadas por provas bioquímicas e serologicas. Os testes bioquímicos utilizados para identificação de Salmonella foram TSI (triple sugar iron àgar), LIA (lysine iron àgar) e ágar ureia. Sorotipagem foi realizada no Laboratório de Enterobactérias do Instituto Osvaldo Cruz. Isolou-se Salmonella Tiphymurium de um pool de linfonodos mesentéricos, provenientes de cinco animais. O fato de se observar a ocorrência de salmonela em ovino portador sadio alerta para necessidade de monitorar este micro-organismo também nesta espécie, especialmente quando destinada ao abate, com vistas à produção de alimentos seguros.

The ovine flock in Brazil is estimated at over 16 million head. Despite that meat consumption of this species is still small when compared to other countries, general meat consumption, including mutton, has been associated to food borne diseases, especially salmonellosis. In the present study, the occurrence of salmonella in mesenteric lymph nodes and intestinal content of 175 ovines during slaughter was investigated. A pool of 5 feces samples or 5 lymph node samples of 25 grams was pre-enriched in 250 mL of buffered peptone water at 37° C for 18-24h. Following this, 0.1 mL of pre-enriched broth was transferred to 9.9 mL of Rappaport-Vassiliadis enrichment broth and 1.0 mL of pre-enriched broth was transferred to 10 mL of Muller-Kaufmann tetrationate broth, incubated at 42° C for 24h. Then, a 10 µL of the enrichment broth was spread on the surface of a BPLS and an XLT4 plate, both incubated at 37º C for 24-48h. Suspected Salmonella colonies were picked from the agar and tested with biochemical and serological methods. Biochemical testing was carried out for the identification of Salmonella, using the TSI (triple sugar iron agar), LIA (lysine iron agar) and urea agar tests. Serotyping was done at the Laboratory of Enterobactérias of the Instituto Osvaldo Cruz. Salmonella Tiphymurium was isolated from a pool of mesenteric lymph nodes from 5 animals. That Salmonella was observed in healthy carrier ovines points out the necessity of monitoring this microorganism in this species as well, especially when animals are destined to slaughter, so to assure safe food production.

Avaliação da suscetibilidade antimicrobiana e do perfil de macrorrestrição do DNA de isolados humanos de Salmonella serovar Typhimurium fagotipo 193, no período de 1970 a 2008 / Assessment of antimicrobial susceptibility and macrorestriction DNA of human isolates of Salmonella serovar typhimurium phage type 193 in the period 1970 to 2008

Para analisar cepas de Salmonella ser. Typhimurium isoladas de processos entéricos e extraintestinais humanos ocorridos no período de 1970 a 2008 de diferentes regiões do país foram selecionadas, com base nos registros contidos no banco de dados do Laboratório de Enterobactérias do IOC/FIOCRUZ, RJ, amostras do fagotipo prevalente 193, visando precipuamente o reconhecimento de clones epidêmicos. Foram selecionadas 553 cepas de Salmonella ser. Typhimurium fagotipo 193 representadas por 91, 65, 70 e 327 amostras referentes as décadas de 70, 80, 90 e ao período de 2000 a 2008, respectivamente. Na análise global da sensibilidade destas cepas, 52% apresentaram um ou mais marcadores de resistência a antibióticos incluídos no perfil ACSSuT. Este perfil de resistência completo foi verificado em 20,9% dos isolados, sendo os 21,9% restantes, sensíveis a todas as drogas testadas, especialmente no período de 2000 a 2008, representadas por 121 amostras (37,0%) em relação as 327 culturas dessa época. O maior percentual de resistência foi observado nas amostras da década de 70 (99%) sendo o perfil ACSSuT detectado em 35,2% dos isolados, ressaltando-se que todas as amostras foram isoladas de processos gastroentéricos ocorridos na cidade de São Paulo. Ao longo das quatro décadas de estudo, descreve-se um ponto de ruptura entre a prevalência de resistência e a suscetibilidade na transição entre as décadas de 80 e 90. Embora o número de isolados de Salmonalla ser. Typhimurium fagotipo 193 tenha aumentado no último período considerado, o percentual de mono e multirresistência aos antimicrobianos se situou em nível elevado (63,0%). A análise do polimorfismo obtido após macrorrestrição com a enzima Xbal revelou que cepas isoladas na década de 90 apresentaram elevado percentual de similaridade (>-85%) com cepas isoladas recentemente (período de 2000-2008), sendo agrupadas nos mesmos "subclusters". Por outro lado, as cepas da década de 70 inserem-se em "subclusters" independentes...

To analyze strains of Salmonella ser. Typhimurium isolated from human cases of enteric and extraintestinal occurred during the period 1970 to 2008 of different regions of Brazil were selected, based on records in the database from Enterobacteria Laboratory of IOC/FIOCRUZ, RJ, samples prevalent phage type 193 in order to recognition of epidemic clones. We selected 553 strains of Salmonella ser. Typhimurium phage type 193 represented by 91, 65, 70 and 327 samples concerning the 1970s, 1980s, 1990s and the period from 2000 to 2008, respectively. In a global analysis of the sensitivity of these strains, 52% had one or more antibiotic resistance markers included in the profile ACSSuT. This resistance profile was found complete in 20.9% of isolates and the remaining 21.9%, sensitive to all drugs tested, especially in the period 2000 to 2008, represented by 121 samples (37.0%) compared the 327 cultures of that time. The highest percentage of resistance was observed in the samples of the 70 (99%) being the profile ACSSuT detected in 35.2% of isolates, emphasizing that all strains were isolated from gastrointestinal processes occurring in São Paulo city. Over the four decades of study, we describe a breaking point between the prevalence of resistance and susceptibility in the transition between the 1980s and 1990s. Although the number of isolates of Salmonella ser. Typhimurium phage type 193 has increased in the last period, the percentage of mono-and-multidrug resistance to antimicrobial agents stood at high level (63.0%). The analysis of polymorphism obtained after macrorestriction with the enzyme Xbal showed that isolates in the 1990s showed a high percentage of similarity (>-85%) with strains isolated recently (2000-2008) and are grouped in the same subclusters. Moreover, the strains of the 1970s fall into subclusters independent, although the percentage of similarity between such subsclusters and the other is >- 70%, the same was observed for the strains...

Simultaneous detection of Escherichia coli O157:H7, toxigenic Vibrio cholera, and Salmonella typhimurium by multiplex PCR

Escherichia coli O157:H7, Vibrio cholerae, and Salmonella typhimurium are pathogenic bacteria found inn contaminated water and food. No assay method is currently available on simultaneous detection or identification of all the three pathogens. Our aim was to develop a rapid and reliable method for this purpose. A protocol for sample collection, and a PCR procedure was designed specifically for the assay. Selected fragments of 239 bp, 432 bp, and 360 bp for E. coli O157 lipopolysaccharide [LPS] gene [rfbE], V. cholerae toxin gene [ctx], and Salmonella typhimurium putative cytoplasmic protein gene [STM4497], respectively, were amplified from the extracted bacterial DNA samples in a single tube by multiplex PCR. The multiplex PCR products were analyzed by gel electrophoresis. All unknown samples were verifiably identified. The assay was sensitive enough to detect and identify as few as 100 cells of E. coli O157:H7, V. cholerae and Salmonella typhimurium. The presence of other bacteria did not interfere with the analysis. This assay is a specific and reliable tool which allows cost-effective detection o all three bacterial pathogens in one reaction tube

Genotoxicidad de Justicia pectoralis Jacq: (tilo) / Genotocixity of Justicia pectoralis Jacq: (tilo)

Objetivo: determinar el efecto genotóxico del extracto hidroalcohólico 30 por ciento de partes aéreas de Justicia pectoralis Jacq. (variedad pectoralis) secado por spray dryer. Métodos: se empleó el ensayo Salmonella/microsomas con las líneas TA 1535, TA 1537, TA 98 y TA 100 con un rango de concentraciones de 50 a 5 000 mg de polvo/placa (± S9) según el protocolo de incorporación en placas; para el ensayo de micronúcleos en médula ósea se utilizaron ratones Cenp: NMRI de los 2 sexos, que recibieron dosis isovolumétricas (10 mL/kg) de 500, 1 000 y 2 000 mg de polvo/kg, por vía intragástrica, separadas 24 h, con sacrificio 24 h después de la última aplicación. Resultados: no se encontró efecto genotóxico con ninguna de las cepas en el ensayo de Salmonella/microsomas y el extracto no causó un aumento estadísticamente significativo en la frecuencia de eritrocitos policromáticos micronucleados en los ratones tratados y no mostró relación dosis respuesta positiva. Conclusiones: el polvo no reveló efecto genotóxico en las condiciones experimentales de este estudio.

Objective: to detemine the genotoxic effect of the hydroalcoholic extract 30 of aerial parts of Justicia pectoralis Jacq. (variety pectoralis) dried by spray drier. Methods: the Salmonella/microsomes with lines TA 1535, TA 1537, TA 98 and TA 100 with a concentration range from 50 to 5 000 ìg of powder/plaque (± S9) was used according to the protocol of incorporation in plaques; for the bone marrow micronucleus assay there were used Cenp mice: NMRI of both sexes that received isovolumetric doses (10 mL/kg) of 500, 1 000 y 2 000 mg of powder/kg by intragastric route at intervals of 24 h and were sacrificed 24 h after the last application. Results: no genotoxic effect was found with any of the strains in the assay of Salmonella/microsomes. The extract did not cause a statistically significant increase in the frequency of micronucleated polychromatic erythrocytes in the mice treated. No dose/positive response relation was observed. Conclusions: the powder did not reveal genotoxic effect under the experimental conditions of this.