Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 39
Filter
1.
Rev. chil. infectol ; 36(4): 433-441, ago. 2019. tab, graf
Article in Spanish | LILACS | ID: biblio-1042659

ABSTRACT

Resumen Introducción: Las infecciones causadas por enterobacterias productoras de β-talactamasas de espectro extendido (EP-BLEE) tienen implicaciones sobre la morbilidad y mortalidad neonatal. Objetivo: Describir la prevalencia de EP-BLEE en sepsis neonatal y los factores asociados. Métodos: Estudio de cohorte prospectivo, desde agosto del 2016 a agosto del 2017. Se incluyeron recién nacidos (RNs) ingresados en el Hospital Civil de Guadalajara "Dr. Juan I. Menchaca". Mediante prueba de difusión de doble disco se indagó la presencia de EP-BLEE y su asociación con características clínicas y demográficas de los RNs. Resultados: Se estudiaron 1.501 RNs hospitalizados, con edad gestacional promedio de 36,3 semanas. Se diagnosticaron 196 eventos de sepsis neonatal, la etiología más frecuente fueron enterobacterias (45,5%); 88,8% demostraron resistencia a ampicilina y más de 42% a cefalosporinas de amplio espectro. El 22,9% presentó fenotipo BLEE positivo. Tener Apgar ≤ 7 a los cinco minutos de vida (OR 4,6; IC 95% 1,47-14,6) y edad gestacional < 37 semanas (OR 5,4; IC 95%1,04-27,7) incrementaron el riesgo. Conclusión: En las enterobacterias causantes de sepsis neonatal, 22,9% son EP-BLEE; la infección es más probable en pacientes con Apgar ≤ 7 a los cinco minutos de vida y en prematuros.


Background: Infections caused by extended-spectrum beta-lactamases enterobacteria (ESBL-EP) have implications for neonatal morbidity and mortality. Aim: To describe the prevalence of ESBL-EP in neonatal sepsis and associated factors. Methods: A prospective cohort study was conducted from August 2016 to August 2017; newborn babies (NB) hospitalized in the Hospital Civil de Guadalajara "Dr. Juan I. Menchaca" were included. The ESBL-EP were investigated by double-disk synergy test and its association with clinical and demographic characteristics of the NB. Results. A total of 1,501 hospitalized NB were studied, with an average gestational age of 36.3 weeks. They were diagnosed 196 neonatal sepsis events, the most frequent etiologies were enterobacteria (45.5%). Resistance to ampicilin was found in 88.8% and to broad spectrum cephalosporins in more than 42% of the strains; 22.9% of them were ESBL phenotype. Apgar ≤ 7 at five minutes of life (OR 4.6; 95% CI 1.47-14.6) and gestational age < 37 weeks (OR 5.4; 95% CI 1.04-27.) increase the risk. Conclusion: In enterobacteria that cause neonatal sepsis, 22.9% were EP-ESBL; infection was more likely in patients with Apgar ≤ 7 at five minutes of age and in preterm infants.


Subject(s)
Humans , Male , Female , Infant, Newborn , Child , Adolescent , Adult , Middle Aged , Young Adult , beta-Lactamases/biosynthesis , Cross Infection/microbiology , Enterobacteriaceae/drug effects , Enterobacteriaceae Infections/microbiology , Neonatal Sepsis/microbiology , Anti-Bacterial Agents/pharmacology , Intensive Care Units, Neonatal , Microbial Sensitivity Tests , Prevalence , Prospective Studies , Risk Factors , Enterobacteriaceae/classification
2.
Braz. j. microbiol ; 49(1): 16-17, Jan.-Mar. 2018.
Article in English | LILACS | ID: biblio-889216

ABSTRACT

ABSTRACT Kosakonia cowanii type strain 888-76T is a human pathogen which was originally isolated from blood as NIH group 42. In this study, we report the complete genome sequence of K. cowanii 888-76T. 888-76T has 1 chromosome and 2 plasmids with a total genome size of 4,857,567 bp and C+G 56.15%. This genome sequence will not only help us to understand the virulence features of K. cowanii 888-76T but also provide us the useful information for the study of evolution of Kosakonia genus.


Subject(s)
Humans , Genome, Bacterial , Enterobacteriaceae/isolation & purification , Enterobacteriaceae/genetics , Enterobacteriaceae Infections/microbiology , Phylogeny , Plasmids/genetics , Base Composition , DNA, Bacterial/genetics , Molecular Sequence Data , Base Sequence , Enterobacteriaceae/classification
3.
Rev. chil. infectol ; 35(3): 329-331, 2018. tab
Article in Spanish | LILACS | ID: biblio-1042647

ABSTRACT

Resumen Actualmente se recomienda el uso de cefazolina para determinar la susceptibilidad a cefalosporinas orales de primera generación en cepas de enterobacterias en ITU no complicada. Nuestro objetivo fue establecer la susceptibilidad a cefalosporinas orales en cepas urinarias según puntos de corte para cefalotina o cefazolina y la correlación de susceptibilidad entre cefazolina y cefadroxilo. Se estudió la concordancia entre cefalotina y cefazolina en 52 cepas por método de Kirby-Bauer y Vitek XL. En Escherichia coli fue de 0% para VitekXL y 50% para Kirby-Bauer. La concordancia entre cefazolina y cefadroxilo fue 95,6%. En el laboratorio debiera usarse cefazolina para determinar susceptibilidad a cefalosporinas orales de primera generación. La concordancia entre cefazolina y cefadroxilo sugiere que cefazolina podría predecir susceptibilidad para cefadroxilo.


Currently, the use of cefazolin is recommended to determine the susceptibility to first-generation oral cephalosporins in strains of enterobacteria in uncomplicated UTI. We determined susceptibility differences to oral cephalosporins in urinary strains according to cefazolin or cefalotin breakpoints and the correlation of susceptibility between cefazolin and cefadroxil. We studied 52 strains with cefalotin and cefazolin by disk-diffusion and MIC (Kirby-Bauer and Vitek XL) and a subgroup by disk-diffusion for cefadroxil. Agreement among different methods was 100% for K. pneumoniae and Proteus spp. In Escherichia coli, agreement for Vitek and disk-diffusion were 0 and 50% respectively. Susceptibility to first generation cephalosporins in E. coli should be determined with cefazolin. Agreement between cefazolin and cefadroxil suggests that cefazolin could also predict the susceptibility of cefadroxil.


Subject(s)
Humans , Cephalosporins/pharmacology , Enterobacteriaceae/drug effects , Anti-Bacterial Agents/pharmacology , Proteus/drug effects , Urinary Tract Infections/microbiology , Microbial Sensitivity Tests/methods , Cefadroxil/pharmacology , Cefazolin/pharmacology , Cephalosporins/classification , Cephalothin/pharmacology , Enterobacteriaceae/classification , Enterobacteriaceae Infections/microbiology , Escherichia coli/drug effects , Klebsiella pneumoniae/drug effects
4.
Mem. Inst. Oswaldo Cruz ; 113(10): e180192, 2018. tab, graf
Article in English | LILACS | ID: biblio-1040581

ABSTRACT

Raoultella planticola is an emerging zoonotic pathogen that is associated with rare but life-threatening cases of bacteremia, biliary tract infections, and urinary tract infections. Moreover, increasing antimicrobial resistance in the organism poses a potential threat to public health. In spite of its importance as a human pathogen, the genome of R. planticola remains largely unexplored and little is known about its virulence factors. Although lipopolysaccharides has been detected in R. planticola and implicated in the virulence in earlier studies, the genetic background is unknown. Here, we report the complete genome and comparative analysis of the multidrug-resistant clinical isolate R. planticola GODA. The complete genome sequence of R. planticola GODA was sequenced using single-molecule real-time DNA sequencing. Comparative genomic analysis reveals distinct capsular polysaccharide synthesis gene clusters in R. planticola GODA. In addition, we found bla TEM-57 and multiple transporters related to multidrug resistance. The availability of genomic data in open databases of this emerging zoonotic pathogen, in tandem with our comparative study, provides better understanding of R. planticola and the basis for future work.


Subject(s)
Polysaccharides, Bacterial/biosynthesis , Genome, Bacterial/genetics , Enterobacteriaceae/genetics , Genes, Bacterial/genetics , Polysaccharides, Bacterial/genetics , Bacterial Capsules/genetics , Enterobacteriaceae/classification
5.
Braz. j. infect. dis ; 21(6): 627-637, Nov.-Dec. 2017. tab
Article in English | LILACS | ID: biblio-888926

ABSTRACT

ABSTRACT This study evaluated the in vitro activity of ceftolozane-tazobactam and comparator agents tested against Latin American isolates of Enterobacteriaceae and Pseudomonas aeruginosa from patients with health care-associated infections. Ceftolozane-tazobactam is an antipseudomonal cephalosporin combined with a well-established β-lactamase inhibitor.A total of 2415 Gram-negative organisms (537 P. aeruginosa and 1878 Enterobacteriaceae) were consecutively collected in 12 medical centers located in four Latin American countries. The organisms were tested for susceptibility by broth microdilution methods as described by the CLSI M07-A10 document and the results interpreted according to EUCAST and CLSI breakpoint criteria. Results: Ceftolozane-tazobactam (MIC50/90, 0.25/32 µg/mL; 84.2% susceptible) and meropenem (MIC50/90, ≤0.06/0.12 µg/mL; 92.6% susceptible) were the most active compounds tested against Enterobacteriaceae. Among the Enterobacteriaceae isolates tested, 6.6% were carbapenem-resistant Enterobacteriaceae and 26.4% exhibited an extended-spectrum β-lactamase non-carbapenem-resistant phenotype. Whereas ceftolozane-tazobactam showed good activity against extended-spectrum beta-lactamase, non-carbapenem-resistant phenotype strains of Enterobacteriaceae (MIC50/90, 0.5/>32 µg/mL), it lacked useful activity against strains with a (MIC50/90, >32/>32 µg/mL; 1.6% S) carbapenem-resistant phenotype. Ceftolozane-tazobactam was the most potent (MIC50//90, 0.5/16 µg/mL) β-lactam agent tested against P. aeruginosa isolates, inhibiting 86.8% at an MIC of ≤4 µg/mL. P. aeruginosa exhibited high rates of resistance to cefepime (16.0%), ceftazidime (23.6%), meropenem (28.3%), and piperacillin-tazobactam (16.4%). Conclusions: Ceftolozane-tazobactam was the most active β-lactam agent tested against P. aeruginosa and demonstrated higher in vitro activity than available cephalosporins and piperacillin-tazobactam when tested against Enterobacteriaceae.


Subject(s)
Humans , Pseudomonas aeruginosa/drug effects , Cephalosporins/pharmacology , Cross Infection/microbiology , Penicillanic Acid/analogs & derivatives , Enterobacteriaceae/drug effects , Anti-Bacterial Agents/pharmacology , Phenotype , Pseudomonas aeruginosa/isolation & purification , Penicillanic Acid/pharmacology , Drug Resistance, Multiple, Bacterial , Enterobacteriaceae/isolation & purification , Enterobacteriaceae/classification , Epidemiological Monitoring , Tazobactam , Latin America
6.
Rev. Soc. Bras. Med. Trop ; 50(2): 173-178, Mar.-Apr. 2017. tab
Article in English | LILACS | ID: biblio-842833

ABSTRACT

Abstract INTRODUCTION: In this study, we used phenotypic methods to screen carbapenem-resistant Enterobacteriaceae (CREs) and evaluated their antimicrobial sensitivity profile. METHODS: One hundred and seventy-eight CREs were isolated at a university hospital in south Brazil in a one-year period. Samples were assessed using disk diffusion tests with inhibitors of β-lactamases such as phenylboronic acid (AFB), cloxacillin (CLOXA), and ethylenediaminetetraacetic acid (EDTA). Strains with differences in zone diameters ≥ 5mm for disks supplemented or not were considered producers of carbapenemases. RESULTS: Klebsiella pneumoniae was the most prevalent CRE, which appeared in 80.3% cases (n = 143). Among clinical materials, the rectal swab was responsible for 43.4% of the isolations (n = 62), followed by urine (18.9%; n = 27). Among the CREs identified in this study, the growth of 56.7% (n = 101) isolates, which were putative producers of Klebsiella pneumoniae carbapenemase (KPC), were inhibited by AFB, whereas 7.3% (n = 13) isolates were inhibited by both AFB and CLOXA and were considered as putative producers of plasmid-mediated AmpC; approximately 3.4% (n = 6) were inhibited by EDTA, which possibly produced metallo-β-lactamase. Lastly, 32.6% (n = 58) cases showed negative results for AFB, CLOXA, and EDTA sensitivity, and represented another class of β-lactamases and/or mechanism of resistance. CONCLUSIONS: Phenotypic screening of CREs is important for clinical laboratories that monitor outbreaks of resistant microbes. Phenotypic tests that use carbapenemase inhibitors and enhancers such as AFB, CLOXA, and EDTA are necessary since they are good screening methods for the detection of carbapenemases.


Subject(s)
Humans , Carbapenems/pharmacology , beta-Lactam Resistance/genetics , Enterobacteriaceae/drug effects , Anti-Bacterial Agents/pharmacology , Phenotype , Microbial Sensitivity Tests , Enterobacteriaceae/classification , Enterobacteriaceae/enzymology , Enterobacteriaceae/genetics , Hospitals, University
7.
Braz. j. microbiol ; 48(1): 132-138, Jan.-Mar. 2017. tab
Article in English | LILACS | ID: biblio-839355

ABSTRACT

Abstract Mastitis adversely affects milk production and in general cows do not regain their full production levels post recovery, leading to considerable economic losses. Moreover the percentage decrease in milk production depends on the specific pathogen that caused the infection and enterobacteria are responsible for this greater reduction. Phenotypic tests are among the currently available methods used worldwide to identify enterobacteria; however they tend to misdiagnose the species despite the multiple tests carried out. On the other hand The Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) technique has been attracting attention for its precise identification of several microorganisms at species level. In the current study, 183 enterobacteria were detected in milk (n = 47) and fecal samples (n = 94) from cows, and samples from water (n = 23) and milk lines (n = 19). All these samples were collected from a farm in Rio de Janeiro with the specific purpose of presenting the MALDI-TOF MS technique as an efficient methodology to identify Enterobacteriaceae from bovine environments. The MALDI-TOF MS technique results matched the biochemical test results in 92.9% (170/183) of the enterobacteria species and the gyrB sequencing confirmed 100% of the proteomic technique results. The amino acid decarboxylation test made the most misidentifications and Enterobacter spp. was the most misidentified genus (76.9%, 10/13). These results aim to clarify the current biochemical errors in enterobacteria identification, considering isolates from a bovine environment, and show the importance for more careful readings of phenotypic tests which are often used in veterinary microbiology laboratories.


Subject(s)
Animals , Female , Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization , Enterobacteriaceae/classification , Enterobacteriaceae/metabolism , Phenotype , Cattle , Sequence Analysis, DNA , DNA Gyrase/genetics , Proteomics/methods , Milk/microbiology , Enterobacteriaceae/isolation & purification , Genes, Bacterial , Mastitis, Bovine/diagnosis , Mastitis, Bovine/microbiology
8.
Rev. Soc. Bras. Med. Trop ; 48(6): 692-698, Nov.-Dec. 2015. tab, graf
Article in English | LILACS | ID: lil-767830

ABSTRACT

Abstract: INTRODUCTION: Nosocomial infections are closely associated with antimicrobial drug resistance. One of the most important mechanisms of resistance to β-lactam antibiotics is the production of extended spectrum β-lactamases (ESBLs). The objective of the present study was to evaluate the prevalence and antimicrobial susceptibility profile of ESBL-producing strains and to assess the evolution of antimicrobial drug resistance between 2007 and 2013 at the Hospital São Vicente de Paulo, Passo Fundo, State of Rio Grande do Sul, Brazil. METHODS: We conducted a descriptive, observational, cross-sectional study. Bacterial culture was performed from January to December 2013. The antimicrobial susceptibility profile of these cultures was determined using the disk diffusion method. Phenotypic screening for ESBL production was performed using the disk approximation method. RESULTS : We analyzed a total of 19,112 cultures, 11.5% of which were positive for Enterobacteriaceae. Of these, 30.3% of the isolates were positive for ESBL production, and the most prevalent species was Klebsiella sp. (37.5%). Over 95% of these isolates showed reduced susceptibility to all cephalosporins, aztreonam, and amoxicillin/clavulanic acid. The isolates also showed high sensitivity to the following antimicrobials: amikacin, meropenem, and piperacillin/tazobactam. Overall, the resistance rates among ESBL-producing Enterobacteriaceae decreased from 2007 to 2013. CONCLUSIONS : In our hospital, the increased sensitivity to certain antimicrobial agents seems to be directly related to the implementation of improvements in the methods to prevent and control nosocomial infections in addition to the natural development of other resistance mechanisms.


Subject(s)
Humans , Anti-Bacterial Agents/pharmacology , Cross Infection/microbiology , Enterobacteriaceae Infections/microbiology , Enterobacteriaceae/drug effects , Enterobacteriaceae/enzymology , beta-Lactamases/biosynthesis , Brazil , Enterobacteriaceae/classification , Microbial Sensitivity Tests , Tertiary Care Centers
9.
Braz. j. microbiol ; 46(4): 1155-1159, Oct.-Dec. 2015. tab
Article in English | LILACS | ID: lil-769667

ABSTRACT

Abstract The antibiotic susceptibility profile was evaluated in 71 Enterobacteriaceae isolates obtained from outpatient urine cultures in July 2010 from two health institutions in Santa Fe, Argentina. The highest rates of antibiotic resistance were observed for ampicillin (AMP) (69%), trimethoprim/sulfamethoxazole (TMS) (33%), and ciprofloxacin (CIP) (25%). Meanwhile, 21% of the isolates were resistant to three or more tested antibiotics families. Thirty integron-containing bacteria (42.3%) were detected, and a strong association with TMS resistance was found. Third generation cephalosporin resistance was detected in only one Escherichia coli isolate, and it was characterized as a blaCMY-2 carrier. No plasmid-mediated quinolone resistance (PMQR) was found. Resistance to fluoroquinolone in the isolates was due to alterations in QRDR regions. Two mutations in GyrA (S83L, D87N) and one in ParC (S80I) were observed in all CIP-resistant E. coli. It was determined to be the main phylogenetic groups in E. coli isolates. Minimum Inhibitory Concentration (MIC) values against nalidixic acid (NAL), levofloxacin (LEV), and CIP were determined for 63 uropathogenic E. coli isolates as MIC50 of 4 μg/mL, 0.03125 μg/mL, and 0.03125 μg/mL, respectively, while the MIC90 values of the antibiotics were determined as 1024 μg/mL, 64 μg/mL, and 16 μg/mL, respectively. An association between the phylogenetic groups, A and B1 with fluoroquinolone resistance was observed. These results point to the importance of awareness of the potential risk associated with empirical treatment with both the families of antibiotics.


Subject(s)
Humans , Anti-Bacterial Agents/pharmacology , Enterobacteriaceae Infections/microbiology , Enterobacteriaceae/drug effects , Enterobacteriaceae/isolation & purification , Quinolones/pharmacology , Urinary Tract Infections/microbiology , beta-Lactams/pharmacology , Argentina , Drug Resistance, Bacterial , Enterobacteriaceae/classification , Enterobacteriaceae/genetics , Genotype , Microbial Sensitivity Tests , Molecular Typing , Outpatients , Phylogeny , Plasmids/analysis
10.
Rev. chil. infectol ; 32(4): 447-452, ago. 2015. tab
Article in Spanish | LILACS | ID: lil-762635

ABSTRACT

Background: Early neonatal sepsis (EOS) is the second leading cause of death in the first week of life. Epidemiology differs in developed and developing countries. Aim: To describe the epidemiology of EOS among newborn patients in a public hospital in western Mexico. Methods: A prospective cohort study was performed in newborns of Nuevo Hospital Civil de Guadalajara "Dr. Juan I Menchaca". EOS was diagnosed with blood cultures or cultures of cerebrospinal fluid within the first 72 h of life. We analyzed risk factors (RF) by multivariate analysis with logistic regression. Results: We identified an EOS incidence of 4.7 events per 1,000 live births. Seventy two percent of the isolated bacteria were gram negative bacilli. Factors associated with EOS were maternal age ≤ 15 years (OR 3.50; 95% CI 1.56-7.85), rupture of membranes > 18 h (OR 2.65; 95% CI 1.18-5.92), maternal fever (OR 6.04; 95% CI 1.54-23.6), birth weight ≤ 2,500 g (OR 4.82; 95% CI 2.38-9.75) and gestational age < 37 weeks (OR 3.14; 95% CI 1.58-6.22). Conclusions: In addition to the RF known for EOS an independent association was observed with maternal age ≤ 15 years.


Introducción: La sepsis neonatal temprana (SNT) es la segunda causa de muerte en la primer semana de vida; la epidemiología difiere en países desarrollados y en vías de desarrollo. Objetivo: Describir la epidemiología de SNT en recién nacidos (RN) de un hospital público del occidente de México. Material y Métodos: Estudio de cohorte prospectivo en RN del Nuevo Hospital Civil de Guadalajara "Dr. Juan I Menchaca". Se diagnosticó SNT con cultivos de sangre o líquido cefalorraquídeo en las primeras 72 h de vida. Se indagaron factores de riesgo (FR) mediante análisis multivariado con regresión logística. Resultados: La incidencia de SNT fue de 4,7 eventos por 1.000 RN vivos. El 72% de las bacterias aisladas correspondió a bacilos gramnegativos. Los factores asociados a SNT fueron la edad materna ≤ 15 años (OR 3,50; IC 95% 1,56-7,85), ruptura de membranas > 18 h (OR 2,65; IC 95% 1,18-5,92), fiebre materna (OR 6,04; IC 95%1,54-23,6), peso al nacimiento ≤ 2.500 g (OR 4,82; IC 95% 2,38-9,75) y edad gestacional < 37 semanas (OR 3,14; IC 95% 1,58-6,22). Conclusiones: Además de los FR ya conocidos para SNT se observó asociación independiente con edad materna ≤ 15 años.


Subject(s)
Female , Humans , Infant, Newborn , Male , Sepsis/epidemiology , Birth Weight , Enterobacteriaceae/classification , Enterobacteriaceae/isolation & purification , Enterococcus/classification , Enterococcus/isolation & purification , Gestational Age , Hospitals, Public , Incidence , Logistic Models , Multivariate Analysis , Mexico/epidemiology , Prospective Studies , Risk Factors , Sepsis/microbiology , Streptococcus/classification , Streptococcus/isolation & purification
11.
Braz. j. infect. dis ; 19(3): 239-245, May-Jun/2015. tab, graf
Article in English | LILACS | ID: lil-751890

ABSTRACT

Objectives: Evaluate risk factors and clinical outcomes of infections caused by Enterobacteriaceae resistant to third-generation cephalosporins present in samples collected upon hospital admission. Methods: Risk factors were evaluated using a 1:2 ratio case-control study. Influence of resistance on the appropriateness of antibiotic therapy, length of stay, and hospital mortality were prospectively evaluated. Characteristics independently associated with the presence of resistant enterobacteria were assessed by logistic regression. Results: Enterobacteria resistant to third-generation cephalosporins were quite common (26.0%). Male gender (OR: 2.66; 95% CI, 1.17-5.06; p = 0.019), invasive prosthesis (OR: 3.79; 95% CI, 1.29-11.08; p = 0.015), previous use of cephalosporins (OR: 2.77; 95% CI, 1.10-6.97; p = 0.029) and hospitalization in the last 6 months (OR: 5.33; 95% CI, 2.29-12.44; p < 0.001) were independently associated with the presence of these microorganisms. These bacteria were associated with higher frequency of inappropriate antimicrobial therapy, worse clinical response, and longer length of stay. Finally, older age, admission to the ICU, and site of infection other than urinary tract were independently associated to higher hospital mortality. Conclusions: Risk factors identified in this study may help in the choice of empirical antibiotic therapy for infected patients suspected of harboring these bacteria and in the early implementation of measures to avoid the spread of these bacteria in the hospital environment. .


Subject(s)
Female , Humans , Male , Middle Aged , Anti-Bacterial Agents/therapeutic use , Cephalosporin Resistance , Cephalosporins/therapeutic use , Enterobacteriaceae Infections/drug therapy , Enterobacteriaceae Infections/microbiology , Enterobacteriaceae/drug effects , Case-Control Studies , Enterobacteriaceae/classification , Hospitals, University , Risk Factors , Treatment Outcome
12.
Rev. Inst. Med. Trop. Säo Paulo ; 57(2): 121-127, Mar-Apr/2015. tab
Article in English | LILACS | ID: lil-744735

ABSTRACT

The evaluation of workers as potential reservoirs and disseminators of pathogenic bacteria has been described as a strategy for the prevention and control of healthcare-associated infections (HAIs). The aim of this study was to evaluate the presence of Enterobacteriaceae in the oral cavity of workers at an oncology hospital in the Midwest region of Brazil, as well as to characterize the phenotypic profile of the isolates. Saliva samples of 294 workers from the hospital’s healthcare and support teams were collected. Microbiological procedures were performed according to standard techniques. Among the participants, 55 (18.7%) were colonized by Enterobacteriaceae in the oral cavity. A total of 64 bacteria were isolated, including potentially pathogenic species. The most prevalent species was Enterobacter gergoviae (17.2%). The highest rates of resistance were observed for β-lactams, and 48.4% of the isolates were considered multiresistant. Regarding the enterobacteria isolated, the production of ESBL and KPC was negative. Nevertheless, among the 43 isolates of the CESP group, 51.2% were considered AmpC β-lactamase producers by induction, and 48.8% were hyper-producing mutants. The significant prevalence of carriers of Enterobacteriaceae and the phenotypic profile of the isolates represents a concern, especially due to the multiresistance and production of AmpC β-lactamases.


A investigação de trabalhadores dos serviços de saúde como reservatório e disseminadores de bactérias patogênicas tem sido referida como estratégia de prevenção e controle das infecções relacionadas à assistência à saúde. Este estudo buscou avaliar a presença de Enterobacteriaceae na cavidade bucal de trabalhadores de hospital oncológico do Centro-Oeste brasileiro, bem como caracterizar o perfil fenotípico dos isolados. Foi coletada amostra de saliva de 294 trabalhadores pertencentes às equipes de saúde e de apoio. Procedimentos microbiológicos foram realizados segundo técnicas referendadas. Dentre os participantes, 55 (18,7%) estavam colonizados por Enterobacteriaceae na cavidade bucal. Foram isoladas 64 bactérias, incluindo espécies potencialmente patogênicas. A espécie mais prevalente foi Enterobacter gergoviae (17,2%). As maiores taxas de resistências foram observadas para os β-lactâmicos e 48,4% dos isolados foram considerados multirresistentes. Para as enterobactérias pesquisadas, a produção de ESBL e KPC foi negativa. Porém, dentre os 43 isolados do grupo CESP, 51,2% foram considerados produtores de β-lactamase AmpC por indução e 48,8% mutantes hiperprodutores. Considera-se a prevalência de portadores de Enterobacteriaceae significativa e o perfil fenotípico dos isolados preocupante, especialmente pela multirresistência e produção de β-lactamases AmpC.


Subject(s)
Humans , Anti-Bacterial Agents/pharmacology , Enterobacteriaceae/isolation & purification , Mouth/microbiology , Personnel, Hospital/statistics & numerical data , Brazil , Cancer Care Facilities , Cross-Sectional Studies , Disease Reservoirs/microbiology , Enterobacteriaceae/classification , Enterobacteriaceae/drug effects , Enterobacteriaceae/metabolism , Microbial Sensitivity Tests , Phenotype
14.
Braz. j. microbiol ; 45(3): 945-952, July-Sept. 2014. graf, mapas, tab
Article in English | LILACS | ID: lil-727025

ABSTRACT

The Port Complex of Maranhão (PCM) is the second largest port complex in Brazil, receiving ships with large volumes of ballast water. To evaluate the microbiological quality of its waters, physicochemical parameters (pH and salinity), the number of coliforms (thermotolerants and totals), and the presence of enterobacterias and diarrheagenic Escherichia coli strains were analyzed. In order to identify the presence of E. coli virulence genes target regions of the stx, elt, est, aggR, CVD432, ipaH and eae nucleotide sequences were studied. The presence of totals and thermotolerants coliforms were positive. Analyzing the salinity parameter, a significant increase in total coliforms was observed during the rainy season. We identified the species Escherichia coli, Proteus mirabilis, Citrobacter freundii, Proteus vulgaris, Klebsiella pneumoniae, Klebsiella ozaenae, Morganella morganii, Enterobacter cloacae and Edwardsiella tarda. Out of the 51 E. coli isolated, two were positive for the elt gene and one was positive for the CVD432 sequence, features of enterotoxigenic and enteroaggregative strains, respectively. This study reveals that the PCM is contaminated by enterobacteria and diarrheagenic E.coli thus providing evidence regarding the risk of these bacteria being carried by ships to other countries, and draws attention to the input of fecal bacteria brought by ships in the port waters of Maranhão.


Subject(s)
Enterobacteriaceae/classification , Enterobacteriaceae/isolation & purification , Water Microbiology , Bacterial Load , Brazil , Chemical Phenomena , Escherichia coli Proteins/genetics , Hydrogen-Ion Concentration , Salinity , Sequence Analysis, DNA , Virulence Factors/genetics , Water/chemistry
15.
Braz. j. infect. dis ; 17(5): 626-628, Sept.-Oct. 2013.
Article in English | LILACS | ID: lil-689892

ABSTRACT

Cedecea represents a genus in the Enterobacteriaceae family that has been rarely associated with human infection. The clinical relevance of Cedecea lapagei has yet to be elucidated. This is the first reported case of pneumonia due to C. lapagei in a patient with acute promyelocytic leukemia.


Subject(s)
Adult , Humans , Male , Enterobacteriaceae Infections/microbiology , Enterobacteriaceae/isolation & purification , Pneumonia, Bacterial/microbiology , Enterobacteriaceae Infections/diagnosis , Enterobacteriaceae Infections/epidemiology , Enterobacteriaceae/classification , Leukemia, Promyelocytic, Acute/complications , Mexico/epidemiology , Pneumonia, Bacterial/diagnosis , Pneumonia, Bacterial/epidemiology
17.
Rev. chil. infectol ; 29(6): 628-634, dic. 2012. graf, tab
Article in Spanish | LILACS | ID: lil-665567

ABSTRACT

Introduction: A significant proportion of water for human consumption has an underground origin becoming 80% in Chilean rural areas where profound wells represent the only search of water for human and animal beverage. Aim: To study the microbiological quality of water from agricultural land for livestock production in the province of Valdivia (40°S), Chile and its potential impact on human health. Material and Method: Water samples were collected monthly (2008 - 2009), at the entrance and exit of a water stream running through the field and in well water used for human and animal consumption. The total coliform (Tc) and Escherichia coli were determined by the confirmatory method Quanti-Tray together with other physicochemical assessments in the water and climatic variables. Results: In samples from the stream water and wells, the Most Probable Number of Tc and E. coli exceeded the standard Chilean Norm of Water Quality (NCh 409/1) for human consumption. Conclusion: These results show the need to regulate the environmental impact of farming and cattle production and to monitor the drinking water to meet the minimum standards of health protection.


Introducción: Parte importante del agua para consumo humano corresponde a agua subterránea, alcanzando un 80% en áreas rurales de Chile, donde los pozos profundos son la única fuente de agua de bebida para consumo humano y animal. Objetivo: Estudiar la calidad microbiológica del agua de un predio agrícola-ganadero en la provincia de Valdivia (40° S), Chile, y su posible impacto en la salud humana. Material y Método: Muestras de agua fueron recolectadas mensualmente (2008-2009), a la entrada y salida de un estero que atraviesa el predio y en agua de pozos usadas para consumo humano y animal. Las especies coliformes totales (Ct) y Escherichia coli se determinaron por el método confirmativo Quanti-Tray, se evaluaron variables físico-químicas del agua y climáticas del sitio. Resultados: En las muestras de agua del estero y pozos el número más probable de Ct y E. coli sobrepasaron la norma chilena de calidad del agua (NCh 409/1) para consumo humano. Conclusión: Estos resultados muestran la necesidad de regular el impacto ambiental de la actividad agrícola-ganadera y monitorear el agua de bebida para cumplir con los estándares mínimos de protección de la salud.


Subject(s)
Animals , Cattle , Humans , Enterobacteriaceae/isolation & purification , Escherichia coli/isolation & purification , Water Microbiology/standards , Water Supply/analysis , Agriculture , Chile , Environmental Monitoring , Enterobacteriaceae/classification , Livestock
18.
Braz. j. pharm. sci ; 47(4): 701-707, Oct.-Dec. 2011. graf
Article in English | LILACS | ID: lil-618062

ABSTRACT

The production of extended-spectrum beta-lactamases (ESBL) is considered one of the most important resistance mechanisms that impair antimicrobial treatment of infections caused by Enterobacteriaceae. Data on culture and susceptibility tests were collected from the Clinical Analyses and Research Laboratory charts reporting on patients admitted to the University Hospital of Maringá (HUM) from January 2004 to December 2009. The following Enterobacteriaceae were selected: Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter spp. and Proteus mirabilis. All tests were performed according to the recommendations of the Clinical and Laboratory Standards Institute (biochemical identification; susceptibility tests; initial screening and phenotypic confirmatory tests for ESBL). For Enterobacter spp. isolates, a disk approximation test was carried out, adding a cefepime disk. Seven hundred samples were analyzed, and E. coli was the most prevalent bacteria (n= 356). ESBLs were detected phenotypically in 7.3 percent of E. coli, 61.7 percent of K. pneumoniae, 33.3 percent of K. oxytoca, 7.1 percent of P. mirabilis, and 13.4 percent of Enterobacter spp samples. Overall ESBL prevalence reached 22 percent when all producers were taken together. Although HUM is considered a small-sized hospital, it showed high levels of resistance to antimicrobial agents, similar to those observed in bigger hospitals, which demonstrated the need for careful epidemiological surveillance.


A produção de beta-lactamases de espectro ampliado (ESBL) é considerada um dos mais importantes mecanismos de resistência aos antimicrobianos, o que dificulta o tratamento de infecções causadas por enterobactérias. Dados sobre cultura e testes de sensibilidade foram coletados das fichas do Laboratório de Ensino e Pesquisa de Análises Clínicas de pacientes atendidos no Hospital Universitário de Maringá (HUM), de janeiro de 2004 a dezembro de 2009. As enterobactérias escolhidas foram: Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter spp. e Proteus mirabilis. Os testes foram realizados de acordo com as recomendações do CLSI (identificação bioquímica; testes de suscetibilidade; triagem e confirmação fenotípica de produção de ESBL). Para isolados de Enterobacter spp., utilizou-se a técnica de disco aproximação, acrescentando um disco de cefepima. Setecentas amostras foram analisadas e E. coli foi a bactéria mais prevalente (n=356). ESBLs foram detectadas fenotipicamente em 7,3 por cento das amostras de E. coli, 61,7 por cento das de K. pneumoniae, 3,3 por cento das de K. oxytoca, 7,1 por cento das de P. mirabilis e em 13,4 por cento das de Enterobacter spp. A prevalência geral de ESBL chegou a 22 por cento, somando-se todos os isolados produtores. O HUM, mesmo sendo considerado um hospital de pequeno porte, apresenta níveis altos de resistência a antimicrobianos, semelhantes àqueles observados em hospitais maiores, demonstrando a necessidade de cuidadosa vigilância epidemiológica.


Subject(s)
beta-Lactamases/analysis , Enterobacteriaceae/classification , Hospitals/statistics & numerical data , Drug Resistance, Bacterial/physiology
19.
Indian J Med Microbiol ; 2011 Apr-June; 29(2): 161-164
Article in English | IMSEAR | ID: sea-143801

ABSTRACT

Purpose: The present study was carried out to characterize the ESBL types and evaluated their in vitro activity against a collection of Gram negative bacteria (GNB) from a multicentric Indian surveillance study. Material and Methods: During January 2005 to June 2006, six tertiary care centres in India forwarded 778 non-duplicate GNB to our reference laboratory. Three hundred GNB from this collection were selected based on clinical significance and were used in the present study. Tested isolates included Escherichia coli (167), Klebsiella spp. (122) and Enterobacter spp. (11). ESBL screening and confirmation was performed for all the isolates. Minimum inhibitory concentration of imipenem, meropenem, ertapenem, levofloxacin, amikacin, piperacillin/tazobactam and ceftriaxone was determined by the E-test method. Molecular typing of the ESBLs was performed by polymerase chain reaction among the 121 selected isolates. Results: The study showed excellent susceptibility among the strains to imipenem (100%), meropenem (100%) and ertapenem (98.7%); good susceptibility to amikacin (89.7%) and piperacillin/tazobactam (85.3%) was observed. TEM and CTX-M were predominantly found in E. coli (39.2%) while, among the Klebsiella spp., TEM, SHV and CTX-M occurred together in 42.6% of the isolates. Conclusion: More than one ESBL was produced by many strains, and this was correlated with increased resistance levels. Carbapenems continue to show good in vitro activity and ertapenem is a potential alternative to imipenem and meropenem. Continued antimicrobial resistance surveillance is warranted in light of these findings.


Subject(s)
Anti-Bacterial Agents/pharmacology , Enterobacteriaceae/classification , Enterobacteriaceae/drug effects , Enterobacteriaceae/enzymology , Enterobacteriaceae/isolation & purification , Enterobacteriaceae Infections/microbiology , Humans , India , Microbial Sensitivity Tests , Molecular Typing , Polymerase Chain Reaction , beta-Lactamases/genetics , beta-Lactamases/metabolism , beta-Lactams/pharmacology
20.
Braz. j. infect. dis ; 15(2): 167-169, Mar.-Apr. 2011. ilus, tab
Article in English | LILACS | ID: lil-582428

ABSTRACT

The objective of this study was to evaluate the susceptibility to cefepime of a large group of ESBL- producing enterobacteria recently isolated in a Brazilian teaching hospital . The study included 280 strains of ESBL-producing enterobacteria, isolated between 2005 and 2008. The presence of the genes blaCTX-M, blaTEM and blaSHV was determined by PCR and confirmed by nucleotide sequencing. Susceptibility testing for cefepime was performed by disc-diffusion, agar dilution method and E-test®. Among the isolates, 34 (12.1 percent) presented a cefepime inhibition zone > 21 and MIC < 8 mg/L by agar dilution and E-strip methods. The use of cefepime for the treatment of infections caused by ESBL-producing bacteria has been controversial. Some studies of PD/PK show the probability of achieving the required PD parameters for cefepime, when the MICs were < 8 mg/L, whereas others have reported therapeutic failure with the same MIC. Additional data is essential to come to terms about the report and treatment with cefepime in ESBL-producing organisms especially when these microorganisms are isolated from sterile sites and from critically ill patients.


Subject(s)
Humans , Anti-Bacterial Agents/pharmacology , Cephalosporins/pharmacology , Enterobacteriaceae/drug effects , beta-Lactamases/biosynthesis , Enterobacteriaceae/classification , Enterobacteriaceae/enzymology , Microbial Sensitivity Tests/methods
SELECTION OF CITATIONS
SEARCH DETAIL