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1.
Arq. bras. med. vet. zootec. (Online) ; 72(4): 1113-1121, July-Aug. 2020. tab, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1131513

ABSTRACT

A proximidade dos primatas não humanos (PNH) com o ser humano pode ser considerada um fator de risco para transmissão de bactérias entre essas duas populações. Neste estudo, foi investigada a microbiota anfibiôntica aeróbica oral e retal de calitriquídeos em um fragmento de Mata Atlântica localizado no Rio de Janeiro, Brasil, e foram realizados testes fenotípicos para detecção de bactérias multirresistentes nos isolados encontrados. Foram capturados 14 calitriquídeos e coletadas 21 amostras (14 de cavidade oral e sete de cavidade retal) em dois pontos da mata próximos às habitações humanas. As espécies mais frequentes, na cavidade oral, foram Klebsiella oxytoca (50,0%), K. pneumoniae (28,6%), Kluyvera ascorbata (21,4%) e Stenotrophomonas maltophilia (21,4%) e, na cavidade retal, K. pneumoniae (85,7%), Escherichia coli (28,6%) e Enterobacter spp. (42,9%). Todos os 48 isolados da família Enterobacteriaceae foram negativos para ESBL (betalactamase de espectro ampliado), mostrando-se não produtores da enzima nos dois métodos utilizados: disco-aproximação e método de detecção automatizado. Na pesquisa de ERC (enterobactérias resistentes a carbapenêmicos), esses mesmos isolados não apresentaram resistência aos antibióticos imipenem, meropenem e ertapenem. Todas as bactérias isoladas apresentam um potencial zoonótico, o que representa um risco à saúde pública e à conservação das espécies.(AU)


Proximity of nonhuman primates (NHP) to humans can be considered a risk factor for transmission of pathogens between these two populations. This study investigated the oral and rectal aerobic bacterial microbiota of marmosets in an anthropized area of the Atlantic Forest located in Rio de Janeiro, Brazil, and performed phenotypic tests for detection of multidrug-resistant bacteria. Twenty-one samples (14 from the oral cavity and seven from the rectum) were collected from 14 Callithrix sp. captured in two sites of the forest near human dwellings. The most frequent species identified from the oral cavity swabs were Klebsiella oxytoca (50.0%), K. pneumoniae (28.6%), Kluyvera ascorbata (21.4%) and Stenotrophomonas maltophilia (21.4%), whereas the species most commonly identified from the rectum swabs were K. pneumoniae (85.7%), Enterobacter spp. (42.9%) and Escherichia coli (28.6%). All isolates of family Enterobacteriaceae showed no extended spectrum ß-lactamase production by disk-diffusion and automated detection tests. In the search for carbapenem-resistant enterobacteriaceae these isolates presented no resistance to the imipenem, meropenem and ertapenem antibiotics. The isolate of Staphylococcus aureus was susceptible to oxacillin and the isolate of Enterococcus was susceptible to vancomycin. All isolated bacteria showed zoonotic potential, thus posing a risk to species conservation and public health.(AU)


Subject(s)
Humans , Animals , Rectum/microbiology , Callithrix/microbiology , Microbiota , Mouth/microbiology , Staphylococcus aureus , Brazil , Disease Transmission, Infectious , Stenotrophomonas maltophilia , Health Risk , Klebsiella oxytoca , Escherichia coli
2.
Rev Bras Ginecol Obstet ; 42(8): 454-459, 2020. tab
Article in English | LILACS | ID: biblio-1137861

ABSTRACT

Abstract Objective Streptococcus agalactiae is an important pathogen in neonates and pregnant women. Neonatal invasive infections due to S. agalactiae are life-threatening and preventive strategies for this challenge of human have become a concern. The aim of the present study was to determine the prevalence of rectovaginal colonization, related risk factors and antibiotic resistance pattern of S. agalactiae among pregnant women in Iran. Methods The present study was performed on 240 pregnant women. Vaginal and rectal swabs were obtained from all of the women and then were transferred to the laboratory. The isolation and identification of S. agalactiae was performed by standard microbiological tests and polymerase chain reaction (PCR) assay. The antimicrobial susceptibility patterns of the isolates were determined by the Kirby-Bauer disk diffusion. Polymerase chain reaction was used to detect ermB and mefA genes in erythromycin-nonsusceptible isolates. Results Out of 240 pregnant women, 16 cases (6.7%) were colonized by S. agalactiae. There is no significant association between demographic-obstetric factors and maternal S. agalactiae colonization in the pregnant women. Linezolid, vancomycin and ampicillin were the most effective antibiotics against S. agalactiae. The ermB gene was present in 6 (35.29%) S. agalactiae isolates. However, the mefA gene was not detected in any of the isolates. Conclusion Given the relatively significant prevalence of S. agalactiae colonization in the pregnant women in the present study and the risk of serious neonatal infections, the screening of pregnant mothers for the bacteria seems necessary. Our findings highlight the importance of appropriate antibiotic prophylaxis during pregnancy for the prevention of early onset S. agalactiae-neonatal infection and comorbidity.


Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Young Adult , Rectum/microbiology , Streptococcal Infections/microbiology , Streptococcal Infections/epidemiology , Streptococcus agalactiae/drug effects , Vagina/microbiology , Streptococcus agalactiae/genetics , Carrier State/microbiology , Carrier State/epidemiology , Microbial Sensitivity Tests , Prevalence , Cross-Sectional Studies , Drug Resistance, Bacterial/genetics , Iran , Middle Aged , Anti-Bacterial Agents/pharmacology
3.
Einstein (Säo Paulo) ; 18: eAO4920, 2020. tab
Article in English | LILACS | ID: biblio-1056062

ABSTRACT

ABSTRACT Objective To evaluate the prevalence of group B Streptococci in pregnant women of a corporate health program, as well as the epidemiological correlations. Methods This retrospective study used medical records of patients who participated of the prenatal care program at a private hospital in the city of São Paulo (SP), Brazil, from 2015 to 2016. Those who abandoned the program or had incomplete data in their medical records were excluded. Quantitative variables were described by means, standard deviations, median, minimal and maximal values. Parity and socioeconomic status were described by absolute frequency and percentages. We used logistic regression models in the software (SPSS) to analyze correlations of variables according to vaginal-rectal culture, considering a 95%CI and p-values. Variables were age, number of pregnancies, weight gain in pregnancy and gestational age at delivery. Results A total of 347 medical records were included, and after applying the exclusion criteria, 287 medical records composed the final sample. Patients' age ranged between 17 and 44 years. Mean age was 30.6 years, 67 patients had positive result for group B Streptococcus (prevalence of 23.3%; 95%CI: 18.7-28.5). Conclusion Considering the high prevalence of group B Streptococcus in our service, the antibiotic prophylaxis strategy based on rectovaginal culture screening approach seems to be cost-effective.


RESUMO Objetivo Identificar a prevalência de estreptococo do grupo B entre gestantes que frequentaram um programa de saúde corporativa, bem como as correlações com a colonização positiva. Métodos Estudo retrospectivo dos prontuários do pré-natal de um hospital privado em São Paulo, no período de 2015 a 2016. Foram excluídas as mulheres que abandonaram o programa ou apresentavam dados incompletos nos prontuários. As variáveis quantitativas foram descritas por média, desvios padrão, mediana, valores mínimos e máximos. A paridade e a condição socioeconômica foram descritos por frequência absoluta e percentagens. Utilizamos modelos de regressão logística no programa (SPSS) para analisar as correlações de variáveis de acordo com a cultura retovaginal, considerando IC95% e valores de p. As variáveis foram idade, número de gestações, peso ganho na gestação e idade gestacional no parto. Resultados Foram incluídos 347 prontuários e, após a aplicação dos critérios de exclusão, 287 prontuários compuseram a amostra final. A idade dos pacientes variou entre 17 e 44 anos. A média de idade foi de 30,6 anos, e 67 pacientes tiveram resultado positivo para o estreptococo do grupo B (prevalência de 23,3%; IC95%: 18,7-28,5). Conclusão Considerando a alta prevalência de estreptococos do grupo B em nosso serviço, existem evidências de que a estratégia de antibiótico profilaxia baseada na cultura retovaginal é custo-efetiva.


Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Young Adult , Pregnancy Complications, Infectious/microbiology , Rectum/microbiology , Streptococcal Infections/microbiology , Streptococcus agalactiae/isolation & purification , Vagina/microbiology , Parity , Pregnancy Complications, Infectious/diagnosis , Pregnancy Complications, Infectious/epidemiology , Prenatal Care , Socioeconomic Factors , Streptococcal Infections/diagnosis , Streptococcal Infections/epidemiology , Brazil/epidemiology , Prevalence , Retrospective Studies , Maternal Age
4.
Rev. argent. coloproctología ; 30(4): 80-87, dic. 2019. graf, tab, ilus
Article in Spanish | LILACS | ID: biblio-1096677

ABSTRACT

Introducción: Las infecciones transmisibles sexualmente (ITS) con afectación anorrectal constituyen un desafío pues las manifestaciones producidas por Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) y Treponema pallidum (TP) son similares. Objetivo: Evaluar si las manifestaciones anorrectales debidas a CT, NG y TP asociadas al examen proctológico permiten diagnóstico certero, sin estudios complementarios. Pacientes y método: Estudio retrospectivo. Revisión de registros de pacientes atendidos en consultorio coloproctológico. Periodo: 01/08/2015-01/07/2016. Se incluyeron pacientes con diagnóstico de ITS anorrectal, excepto aquellos con HPV únicamente. A todos se les pesquisaron ITS mediante hisopado anal para CT por inmunofluorescencia y para estudio directo y cultivo de NG, VDRL para TP y además HIV. Variables: sexo, edad, HIV, sexo anal, uso de preservativo, motivo de consulta y resultado de estudios efectuados. Resultados: Treinta y cuatro pacientes (32 hombres). Edad mediana 31,5 años (rango: 19-65). Veinticinco pacientes HIV + (73,5%). Veintinueve pacientes (28 hombres) mantenían sexo anal. 91% no usaba preservativo adecuadamente. 65% tuvo una única infección (ITS pura). Se diagnosticaron 14 sífilis (8 puras), 14 clamidiasis (7 puras) y 11 gonococcias (7 puras). Co-infección entre ellas: 9% y con HPV: 26%. La úlcera fue la manifestación en 7/8 casos de sífilis puras (todas dolorosas, excepto una). El resto presentó síntomas variados (condilomas virales atípicos, secreción purulenta y proctorragia). Más del 50% de las gonococias puras (4/7) se manifestó con úlcera, sin embargo, el dolor estuvo presente siempre (8/8) y en tres se asoció secreción purulenta. En cambio, la mitad de los pacientes con clamidiasis puras, se manifestó con proctorragia causada por un tumor rectal/sigmoideo inflamatorio, clínicamente indistinguible de neoplasia maligna. Todos las sífilis y gonococias tuvieron correlato con las pruebas diagnósticas, no así las clamidiasis cuyo diagnóstico no pudo confirmarse en tres casos (37,5%), que respondieron al tratamiento empírico. Conclusión: NG y TP anorrectal provocaron mayormente síntomas similares a los de etiología no venérea y se requirió del laboratorio para el diagnóstico etiológico. La presencia de tumor con biopsia negativa para neoplasia maligna en pacientes de riesgo para ITS obliga a descartar clamidiasis. (AU)


Introduction: Sexually transmitted infections (STIs) are a challenge in medical consultation. The clinical manifestations of infection by Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Treponema pallidum ( TP) share symptoms at anorectal level. This implies the need for a high index of suspicion for diagnosis, which is based on history, physical examination and laboratory tests that not always are accurate or available . Purpose: Assess whether clinical signs of anorectal infections by CT, NG and TP associated with proctologic exams, lead to an accurate etiologic diagnosis without the help of specific laboratory studies. Patients and methods: Observational, retrospective study, based on a review of records of patients treated at the outpatient clinic of the Hospital Fernandez (City of Buenos Aires) department of coloproctology, in the period between August 2015 and July 2016. Patients who underwent STI diagnosis were all considered, but to those whose only diagnosis was infection by human papilloma virus (HPV) were excluded from the analysis. All patients were tested after the three etiologies of STI (anal swab for CT study by immunofluorescence, swabbing for direct study, and cultivation of NG and TP VDRL) and HIV. Variables analyzed: sex, age, presence of HIV infection, practice of receptive anal sex, proper use of condoms, signs and symptoms that prompted the consultation, and results of diagnostic tests. Results: 34 patients (32 men) were included. Median age 31.5 years (range: 19-65, interquartile range: 26-37). Twenty-five patients (73.5%) were HIV+. Twenty-nine patients (28 men) remained receptive anal sex. 91% did not use condoms properly. 65% of infections were pure, without other STI asociada-. 14 cases of syphilis (8 pure), 14 Chlamydia (7 pure) and 11 gonococcias (7puras), including co-infection in 9% of cases, no evidence of a more frequent another co-infection diagnosed. Co-infection with HPV was detected in 9 (26%) cases. The ulcer was the sign in 7/8 cases of pure syphilis (all painful, except one). The rest is expressed by a variety of symptoms (atypical viral warts, purulent and bloody diarrhea). Similarly, just over 50% (4/7) of pure gonococcias demonstrated ulcer, but the pain was always present (8/8 of pure gonococcias) and three associated with purulent discharge. Instead of the ten patients with pure chlamydia, 50% manifested with bloody diarrhea caused by a rectal tumor / inflammatory sigmoid, clinically indistinguishable from malignancy. All cases of syphilis and gonococcal were correlated with diagnostic tests; not those whose diagnosis of chlamydial infection (confirmed in eight and was negative in three, 37.5%) who responded to empiric treatment indicated by the clinical suspicion. Conclusion: While this is a small series, it shows that the NG and TP in the anorectal location mostly caused symptoms similar to those of non-venereal ethology most of the times, and laboratory assistance for etiologic diagnosis was required. The presence of tumor with negative biopsy for malignancy in patients at risk for STIs, leads chlamydia to be ruled out. (AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Young Adult , Proctitis/etiology , Proctitis/microbiology , Sexually Transmitted Diseases, Bacterial/complications , Sexually Transmitted Diseases, Bacterial/diagnosis , Chlamydia Infections/diagnosis , Gonorrhea/diagnosis , Syphilis/diagnosis , Pain , Proctitis/epidemiology , Rectum/microbiology , Sexually Transmitted Diseases, Bacterial/epidemiology , Comorbidity , HIV Infections , Retrospective Studies , Sex Distribution , Clinical Laboratory Techniques
5.
Rev. chil. infectol ; 35(3): 253-261, 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-959439

ABSTRACT

Resumen Introducción: Las Enterobacteriaceae productoras de carbapenemasas (EPC) han tomado gran importancia en salud pública a una escala global, haciendo necesario implementar test rápidos para su detección oportuna. Objetivo: Evaluar tres metodologías para el tamizaje de EPC en hisopados rectales. Materiales y Métodos: Estudio prospectivo transversal. Se evaluaron 73 hisopados rectales por tres metodologías. Se realizó identificación y evaluación de susceptibilidad por sistemas automatizados y la producción de carbapenemasas se confirmó por test de Hodge modificado, sinergia con ácido borónico y EDTA. Resultados: Método 1 (ChromID CARBA®): detectó 20 muestras positivas (27,4%), 5 falsos positivos (6,9%), con índice de concordancia de 93,2%, sensibilidad 100% y especificidad de 90%. Método 2 (HB&L Carbapenemase®): detectó 17 muestras positivas (23,3%) y 3 falsos negativos (4,1%). La sensibilidad y especificidad fue 85 y 100% respectivamente, con concordancia de 95,9%. Método 3 (Xpert Carba-R®): detectó 19 muestras positivas (57,5 %) y 1 falso negativo (3,1%), sensibilidad 95%, especificidad 100% e índice de concordancia de 97%. Discusión: Existe amplia variedad de metodologías para búsqueda y detección rápida de microorganismos productores de carbapenemasas. La elección del método debe tener como requisito una buena sensibilidad y especificidad, rapidez y costo efectividad.


Background: Carbapenemase-producing Enterobacteriaceae (CPE) have taken great importance on public health at global scale, which makes it necessary to implement rapid test for its prompt detection. Aim: To evaluate three screening methods to detect CPE in rectal swabs. Material and Methods: Transverse study, prospective. Seventy three rectal swabs were evaluated by three methodologies. Microorganism identification and susceptibility testing were made using automated systems. Carbapenemase production was confirmed by modified Hodge test and synergy tests using boronic acid and EDTA. Results: The method 1 (ChromID CARBA®) detected 20 positive samples (27.4%), 5 false positives (6.9 %), with concordance index of 93.2%, sensitivity 100% and specificity of 90%. Method 2 (HB&L Carbapenemase®) detected 17 positive samples (23.3%) and 3 false negatives (4.1%). The sensitivity and specificity of the assay were 85% and 100%, with concordance index of 95.9%. Method 3 (Xpert Carba-R®) detected 19 positive samples (57.5%) and 1 false negatives (3.1%), sensitivity 95%, specificity 100% and concordance index of 97%. Discussion: There is a wide variety of methodologies for rapid detection of carbapenemase-producing microorganisms. Choosing the best method must have as requirement a good sensitivity, specificity, and cost-effectiveness.


Subject(s)
Humans , Rectum/microbiology , Mass Screening/methods , Bacteriological Techniques/methods , Enterobacteriaceae Infections/diagnosis , Enterobacteriaceae Infections/microbiology , Carbapenem-Resistant Enterobacteriaceae/isolation & purification , Cross-Sectional Studies , Prospective Studies , Sensitivity and Specificity
6.
Braz. j. microbiol ; 48(4): 715-723, Oct.-Dec. 2017. tab, graf
Article in English | LILACS | ID: biblio-889177

ABSTRACT

ABSTRACT The ability to adsorb zearalenone by five strain of lactic acid bacteria was evaluated: four strains of Lactobacillus spp. isolated from pig rectal swabs and one commercial strain (Lactobacillus rhamnosus). Several factors affecting the adsorption capacity were evaluated in order to improve the adsorption of the mycotoxin by bacteria. The stability of the zearalenone-bacteria complex was analyzed. In every case, bacterial adsorption capacity was higher than 40.0%. The strain showing the highest adsorption (68.2%) was selected for the following steps of this research. The adsorption percentages obtained after processing 6.5 and 7.5 mL MRS broth were 57.40% + 3.53 and 64.46% + 0.76, respectively. The stability of zearalenone-bacteria complex was evaluated by successively rinsing. In the first rinsing step 42.26% + 0.414 was still bound. In the second rinsing step 25.12% + 0.664 was still bound, whereas 15.82% + 0.675 remained in the pellet after the third rinse. Results obtained demonstrated that Lactic Acid Bacteria has capacity to adsorb zearalenone. Finally adsorption was increased using a higher volume of initial broth. These results could be used to design a new lyophilized powder for detoxification, using lactic acid bacteria as potential zearalenone adsorbents.


Subject(s)
Animals , Lactobacillus/metabolism , Swine/microbiology , Zearalenone/metabolism , Adsorption , Lactobacillus/chemistry , Lactobacillus/genetics , Lactobacillus/isolation & purification , Rectum/microbiology , Zearalenone/chemistry
7.
Braz. j. infect. dis ; 20(6): 569-575, Nov.-Dec. 2016. tab
Article in English | LILACS | ID: biblio-828154

ABSTRACT

ABSTRACT Background: Infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae are the most common bacterial sexually transmitted infections throughout the world. These sexually transmitted infections are a growing problem in people living with HIV/AIDS. However, the presence of these agents in extra genital sites, remains poorly studied in our country. The objective of this study was to estimate the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae anal and genital infection in people living with HIV/AIDS followed in a reference center in Salvador, Brazil. Methods: Cross-sectional study, from June 2013 to June 2015. Proven HIV-infected people attending this reference center were invited. Clinical and epidemiological data were obtained through interview with standardized form. Chlamydia trachomatis and Neisseria gonorrhoeae screening was performed using qPCR (COBAS 4800® Roche). Results: The frequency of positive cases of Chlamydia trachomatis and Neisseria gonorrhoeae was 12.3% in total, 9.2% cases amongst women and 17.1% amongst men. We found 14.0% of positive cases in anus and 3.1% in genital region in men, while 5.6% and 3.6%, in women, respectively. Among men, anal infection was associated with age <29 years (p = 0.033), report of anal intercourse (p = 0.029), pain during anal intercourse (p = 0.028). On the other hand, no association between genital infection and other variables were detected in bivariate analysis. Among women, we detected an association between Chlamydia trachomatis genital infection and age <29 years (p < 0.001), younger age at first sexual intercourse (p = 0.048), pregnancy (p < 0.001), viral load >50 copies/mL (p = 0.020), and no antiretroviral use (p = 0.008). Anal infection in women was associated with age <29 years old (p < 0.001) and pregnancy (p = 0.023), and was not associated with report of anal intercourse (p = 0.485). Conclusion: Missed opportunities for diagnosis in extra genital sites could impact on HIV transmission. The extra genital sites need to be considered to break the HIV and bacterial sexually transmitted infections chain-of-transmission.


Subject(s)
Humans , Male , Female , Pregnancy , Adult , Rectum/microbiology , Chlamydia Infections/epidemiology , Gonorrhea/epidemiology , AIDS-Related Opportunistic Infections/epidemiology , Genitalia, Female/microbiology , Socioeconomic Factors , Brazil/epidemiology , Chlamydia Infections/diagnosis , Gonorrhea/diagnosis , Chlamydia trachomatis/isolation & purification , Prevalence , Cross-Sectional Studies , AIDS-Related Opportunistic Infections/diagnosis , AIDS-Related Opportunistic Infections/microbiology , Neisseria gonorrhoeae/isolation & purification
8.
Braz. j. infect. dis ; 20(2): 134-140, Mar.-Apr. 2016. tab, graf
Article in English | LILACS | ID: lil-780802

ABSTRACT

Abstract Background Little is known about factors associated with carbapenem-resistant Klebsiella pneumoniae infections in pediatric patients, who are initally colonized with carbapenem-resistant Klebsiella pneumoniae. Materials and methods A retrospective case–control study was conducted involving pediatric and neonatal intensive care units throughout a five-year period (January 2010–December 2014). Clinical and microbiological data were extracted from Hospital Infection Control Committee reports and patients’ medical records. Risk factors were assessed in carbapenem-resistant Klebsiella pneumoniae colonized patients who developed subsequent systemic infection (cases) and compared to carbapenem-resistant Klebsiella pneumoniae colonized patients who did not develop infection (controls). Results Throughout the study period, 2.6% of patients admitted to neonatal intensive care units and 3.6% of patients admitted to pediatric intensive care units had become colonized with carbapenem-resistant Klebsiella pneumoniae. After a mean of 10.6 ± 1.9 days (median: 7 days, range: 2–38 days) following detection of colonization, 39.0% of the carbapenem-resistant Klebsiella pneumoniae colonized patients in pediatric intensive care units and 18.1% of carbapenem-resistant Klebsiella pneumoniae colonized patients in neonatal intensive care units developed systemic carbapenem-resistant Klebsiella pneumoniae infection. Types of systemic carbapenem-resistant Klebsiella pneumoniae infections included bacteremia (n = 15, 62.5%), ventilator-associated pneumonia (n = 4, 16.6%), ventriculitis (n = 2, 8.3%), intraabdominal infections (n = 2, 8.3%), and urinary tract infection (n = 1, 4.1%). A logistic regression model including parameters found significant in univariate analysis of carbapenem resistant Klebsiella pneumoniae colonization and carbapenem resistant Klebsiella pneumoniae infection groups revealed underlying metabolic disease (OR: 10.1; 95% CI: 2.7–37.2), previous carbapenem use (OR: 10.1; 95% CI: 2.2–40.1), neutropenia (OR: 13.8; 95% CI: 3.1–61.0) and previous surgical procedure (OR: 7.4; 95% CI: 1.9–28.5) as independent risk factors for carbapenem-resistant Klebsiella pneumoniae infection in patients colonized with carbapenem-resistant Klebsiella pneumoniae. Out of 24 patients with carbapenem resistant Klebsiella pneumoniae infection, 4 (16.6%) died of carbapenem-resistant Klebsiella pneumoniae sepsis. Conclusion Asymptomatic colonization with carbapenem-resistant Klebsiella pneumoniae in intensive care units of pediatric departments should alert health care providers about forthcoming carbapenem-resistant Klebsiella pneumoniae infection. Those carbapenem-resistant Klebsiella pneumoniae colonized patients at risk of developing infection due to carbapenem-resistant Klebsiella pneumoniae may be targeted for interventions to reduce subsequent infection occurence and also for timely initiation of empirical carbapenem-resistant Klebsiella pneumoniae active treatment, when necessary.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Klebsiella Infections/microbiology , Carbapenems/pharmacology , Cross Infection/microbiology , Drug Resistance, Bacterial , Klebsiella pneumoniae/drug effects , Anti-Bacterial Agents/pharmacology , Rectum/microbiology , Klebsiella Infections/epidemiology , Intensive Care Units, Neonatal , Cross Infection/epidemiology , Epidemiologic Methods , Disease Progression , beta-Lactam Resistance , Disk Diffusion Antimicrobial Tests , Klebsiella pneumoniae/isolation & purification
9.
Braz. j. microbiol ; 46(4): 1257-1263, Oct.-Dec. 2015. tab
Article in English | LILACS | ID: lil-769651

ABSTRACT

Increasing interactions between humans, domestic animals and wildlife may result in inter-species transmission of infectious agents. To evaluate the presence of pathogenic E. coli and Salmonella spp. and to test the antimicrobial susceptibility of isolates, rectal swabs from 36 different free-ranging wild mammals were taken from two distinct natural sites in Brazil: Cantareira State Park (CSP, state of São Paulo) and Santa Isabel do Rio Negro Region (SIRNR, state of Amazonas). The swabs were randomly collected and processed for bacterial isolation, identification, characterization and antimicrobial resistance. Eighteen E. coli strains from CSP and 20 from SIRNR were recovered from 14 and 22 individuals, respectively. Strains from animals captured in CSP, the site with the greatest anthropization, exhibited a higher range and percentage of virulence genes, including an eae+/bfpA+ strain. Antimicrobial resistance was verified in strains originating from both sites; however, in strains from SIRNR, aminopenicillins were almost the exclusive antimicrobial class to which strains exhibited resistance, whereas in CSP there were strains resistant to cephalosporins, sulfonamide, aminoglycoside, tetracycline and fluoroquinolone, in addition to strains exhibiting multidrug resistance. Two strains of Salmonella enterica that are known to be associated with reptiles, serotypes Belem and 60:r:e,n,z15, were recovered only from Amazonian animals and showed susceptibility to all classes of antimicrobials that were tested. Although the potential impact of these pathogens on wildlife remains unknown, bacteria isolated from free-ranging wild animals may provide relevant information about environmental health and should therefore be more deeply studied.


Subject(s)
Animals , Animals, Wild , Escherichia coli Infections/epidemiology , Escherichia coli Infections/veterinary , Escherichia coli/isolation & purification , Salmonella Infections, Animal/epidemiology , Salmonella Infections, Animal/microbiology , Salmonella enterica/isolation & purification , Brazil/epidemiology , Drug Resistance, Bacterial , Escherichia coli Infections/microbiology , Escherichia coli/drug effects , Escherichia coli/genetics , Rectum/microbiology , Salmonella enterica/drug effects , Salmonella enterica/genetics , Virulence Factors/analysis , Virulence Factors/genetics
10.
Rev. chil. infectol ; 32(4): 393-398, ago. 2015. ilus, tab
Article in Spanish | LILACS | ID: lil-762636

ABSTRACT

Background: The isolation of vancomycin-resistant Enterococcus spp (ERV) has increased significantly within the last few years, along with the risk of infection and dissemination of these bacteria. Our aim was to determine risk factors (RF) for intestinal colonization in hospitalized pediatric patients with oncological disease at Hospital de Niños Roberto del Río. Methods: Between January 2012 and December 2013 a transversal study was performed with 107 rectal swabs and processed with a PCR for ERV. The patients were classified as "colonized with ERV" and "not colonized with ERV" and we evaluated possible RF for intestinal colonization in both groups. Results: VRE colonization was found in 51 patients (52%). The median of time elapsed between oncological diagnosis and VRE colonization was 35 days. The significant RF associated with VRE colonization were days of hospitalization prior to study, neutropenia and treatment with antibiotics within 30 days prior to study and mucositis. Conclusions: According to the RF revealed in this study we may suggest prevention standards to avoid ERV colonization. This is the first investigation in our country in hospitalized pediatric patients with oncological disease and processed with a multiplex PCR for ERV, therefore it is a great contribution about this subject in Chile.


Introducción: El aislamiento de Enterococcus spp resistentes a vancomicina (ERV) ha presentado un incremento significativo en los últimos años, aumentando el riesgo de infección por esta bacteria y favoreciendo su diseminación. Nuestro objetivo es determinar los factores de riesgo (FR) de colonización intestinal de ERV en pacientes oncológicos internados en el Hospital de Niños Roberto del Río. Método: Entre enero de 2012 y diciembre de 2013 se realizó un estudio transversal de colonización rectal por ERV mediante muestras de hisopado rectal obtenidas en 107 pacientes efectuando RPC múltiple para ERV. Se dividió en grupo "portador" y "no portador" y se evaluó los posibles FR para colonización por ERV. Resultados: Se encontró colonización por ERV en 51 pacientes (52%). El tiempo transcurrido desde el diagnóstico oncológico y la colonización presentó una mediana de 35 días. Los FR encontrados con asociación significativa fueron el número de días de hospitalización previa, neutropenia, uso de antimicrobianos 30 días previos y mucositis. Conclusión: De acuerdo a los FR encontrados podemos sugerir medidas de prevención para colonización por ERV. Esta es la primera investigación realizada en nuestro país en pacientes oncológicos pediátricos y que utiliza la técnica de RPC múltiple para ERV, lo que permite un aporte significativo sobre este tema en Chile.


Subject(s)
Child , Child, Preschool , Female , Humans , Male , Hospitalization , Intestines/microbiology , Leukemia, Myeloid, Acute/microbiology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/microbiology , Rectum/microbiology , Vancomycin-Resistant Enterococci/isolation & purification , Case-Control Studies , Cross-Sectional Studies , Cross Infection/microbiology , Length of Stay , Leukemia, Myeloid, Acute/complications , Multiplex Polymerase Chain Reaction , Mucositis/complications , Mucositis/microbiology , Neutropenia/complications , Neutropenia/microbiology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications , Risk Factors , Vancomycin Resistance , Vancomycin-Resistant Enterococci/classification
12.
Braz. j. microbiol ; 45(4): 1531-1539, Oct.-Dec. 2014. ilus
Article in English | LILACS | ID: lil-741310

ABSTRACT

Black lion tamarins (Leontopithecus chrysopygus) are endangered callithrichids. Their conservation may require future translocations or reintroductions; however these approaches involve risks of pathogen introduction in the environment and stress-related opportunistic infections in these animals. In order to screen for opportunistic and potential pathogenic bacterial and fungal microbiota, ten free-ranging and ten captive Black lion tamarins were studied and the results compared. Nasal, oral and rectal swabs were collected and cultured for aerobic and facultative anaerobic bacteria and fungi, and a total 203 bacterial and 84 fungal isolates were obtained. Overall, the most frequent organisms were Staphylococcus spp., Bacillus spp., Candida spp. and Aspergillus spp. Microbiota of free-ranging and captive animals were similar in composition. A number of potentially pathogenic organisms were identified, emphasizing the importance of microbiological screening in future translocation or reintroduction conservation management programs.


Subject(s)
Animals , Bacteria/classification , Fungi/classification , Leontopithecus/microbiology , Microbiota , Mouth/microbiology , Nasal Cavity/microbiology , Rectum/microbiology , Bacteria/growth & development , Bacteria/isolation & purification , Fungi/growth & development , Fungi/isolation & purification , Microbiological Techniques
13.
Braz. j. microbiol ; 44(4): 1173-1180, Oct.-Dec. 2013. ilus, tab
Article in English | LILACS | ID: lil-705281

ABSTRACT

This study described a group of strains obtained from a slaughter house in Mendoza, in terms of their pathogenic factors, serotype, antibiotype and molecular profile. Ninety one rectal swabs and one hundred eight plating samples taken from carcasses of healthy cattle intended for meat consumption were analyzed. Both the swab and the plate samples were processed to analyze the samples for the presence of virulence genes by PCR: stx1, stx2, eae and astA. The Stx positive strains were confirmed by citotoxicity assay in Vero cells. The isolates were subsequently investigated for their O:H serotype, antimicrobial susceptibility and molecular profile by Random Amplification of Polymorphic DNA (RAPD). Twelve E.coli strains were identified by their pathogenicity. Nine were from fecal origin and three from carcasses. Three strains carried the stx1 gene, three the stx2 gene, two carried eae and four the astA gene. The detected serotypes were: O172:H-; O150:H8; O91:H21; O178:H19 and O2:H5. The strains showed a similarity around 70% by RAPD. Some of the E.coli strains belonged to serogroups known for certain life-threatening diseases in humans. Their presence in carcasses indicates the high probability of bacterial spread during slaughter and processing.


Subject(s)
Animals , Cattle , Carrier State/veterinary , Escherichia coli Infections/veterinary , Shiga-Toxigenic Escherichia coli/genetics , Shiga-Toxigenic Escherichia coli/pathogenicity , Virulence Factors/analysis , Abattoirs , Argentina , Bacterial Toxins/analysis , Bacterial Toxins/genetics , Cell Survival , Chlorocebus aethiops , Carrier State/microbiology , Escherichia coli Infections/microbiology , Microbial Sensitivity Tests , Molecular Typing , Polymerase Chain Reaction , Rectum/microbiology , Serotyping , Shiga-Toxigenic Escherichia coli/classification , Shiga-Toxigenic Escherichia coli/isolation & purification , Vero Cells , Virulence Factors/genetics
14.
Article in English | WPRIM | ID: wpr-119342

ABSTRACT

BACKGROUND: Group B streptococcus (GBS) infection is a leading cause of neonatal morbidity and mortality worldwide. Here, we present the analytical and diagnostic usefulness of a new real-time PCR-based assay (Xpert GBS; Cepheid, USA) for rapid and accurate prenatal GBS screening. METHODS: We enrolled 175 pregnant women who were between 35 and 39 weeks of gestation. The analytical performance of the Xpert GBS assay was first tested using a reference GBS strain. Next, to test diagnostic performance, rectovaginal swabs were obtained from pregnant women who visited the hospital for regular antenatal screening after 34 weeks of gestation. The results of the Xpert GBS assay were compared to those of standard culture for the detection of prenatal GBS colonization. RESULTS: When any positive result from Xpert GBS or culture was considered a true positive, the sensitivity of the Xpert GBS assay and culture were 91% (20/22; 95% CI [confidence interval], 72-98) and 68% (15/22; 95% CI, 47-84), respectively. The specificity of both methods was 100% (153/153; 95% CI, 97-100). The sensitivity and specificity of the Xpert GBS assay, using the culture results as a reference, were 86.7% and 95.6%, respectively. In the Xpert GBS assay, the median threshold cycle of vaginally colonized samples was significantly lower than rectally colonized samples (P<0.01). CONCLUSIONS: The Xpert GBS assay is an accurate, rapid, easy-to-use test for the detection of maternal GBS colonization in prenatal screening that might be especially useful in clinical settings where standard culture is not feasible.


Subject(s)
DNA, Bacterial/analysis , Female , Gestational Age , Humans , Pregnancy , Pregnancy Complications, Infectious/diagnosis , Prenatal Diagnosis , Reagent Kits, Diagnostic , Real-Time Polymerase Chain Reaction , Rectum/microbiology , Sensitivity and Specificity , Streptococcal Infections/diagnosis , Streptococcus agalactiae/genetics , Vagina/microbiology
15.
Article in English | WPRIM | ID: wpr-178348

ABSTRACT

BACKGROUND: Active screening for vancomycin-resistant enterococci (VRE) using rectal specimens is recommended to limit the spread of antimicrobial resistance within certain high-risk populations. We evaluated the diagnostic performance of Vancomycin Resistance 3 Multiplexed Tandem PCR assay (AusDiagnostics, Australia), a rapid multiplex real-time PCR assay that detects vanA and/or vanB. METHODS: Two-hundred-and-eleven rectal swabs from Hematology and Oncology unit were submitted for VRE surveillance via direct detection of vanA and/or vanB by culture and by using Vancomycin Resistance 3 Multiplexed Tandem PCR assay. Enterococci were identified to the species level by using standard biochemical tests and BD Phoenix Automated Microbiology System (BD Diagnostic Systems, USA). Vancomycin susceptibility of enterococci was determined using Etest (BioMerieux, France). RESULTS: Compared to the culture method, Vancomycin Resistance 3 Multiplexed Tandem PCR assay had a sensitivity of 84.0%, specificity of 98.8%, positive predictive value (PPV) of 91.3%, and negative predictive value (NPV) of 97.6%. The assay failed to detect 18 (8.5%) specimens because of the presence of PCR inhibitors; of the remaining 193 specimens, 25 (12.9%) were positive, 23 for vanA, and 2 for vanB. Although both sensitivity and specificity for vanA VRE was 100% compared to the culture method, all vanB-positive specimens tested negative by VRE culture. CONCLUSIONS: Vancomycin Resistance 3 Multiplexed Tandem PCR assay is a rapid and laborsaving option for VRE surveillance for direct use on rectal swabs. However, the high rate of PCR failure owing to the inhibitors in the specimens and the low specificity for vanB should be considered when interpreting the results.


Subject(s)
Bacterial Proteins/genetics , Carbon-Oxygen Ligases/genetics , DNA, Bacterial/analysis , Enterococcus/drug effects , Humans , Multiplex Polymerase Chain Reaction , Reagent Kits, Diagnostic , Rectum/microbiology , Sensitivity and Specificity , Vancomycin/pharmacology , Vancomycin Resistance/genetics
16.
Article in English | WPRIM | ID: wpr-144104

ABSTRACT

This study aimed to investigate whether CHROMagar Acinetobacter medium (CHROMagar, France) in combination with an antimicrobial supplement (modified CHROMagar Acinetobacter; CHROMagar, France) can be used for detecting and isolating multidrug-resistant Acinetobacter species (MRA) in nasal and rectal surveillance cultures. Nasal and rectal swab samples were collected from patients in an intensive care unit at a teaching hospital. The samples were used to inoculate modified CHROMagar Acinetobacter plates, which were examined after 24 and 48 hr of incubation at 37degrees C. Their susceptibility against the antimicrobial agents meropenem, imipenem, ciprofloxacin, and amikacin was analyzed using the Etest (bioMerieux, France). A total of 406 paired samples (406 nasal swabs and 406 rectal swabs) were obtained from 226 patients, and 120 samples (28 nasal and 28 rectal cultures, 47 nasal cultures only, and 17 rectal cultures only) yielded MRA. Seventy-five MRA isolates (18.5%) were recovered from the 406 nasal samples, and 45 MRA isolates (11.1%) were recovered from the 406 rectal samples. Of the 120 MRA isolates, 3 (2.5%) were detected only after 48 hr of incubation. The use of modified CHROMagar Acinetobacter together with nasal and rectal swabs and 1-day incubation is an effective surveillance tool for detecting MRA colonization.


Subject(s)
Acinetobacter/drug effects , Acinetobacter Infections/diagnosis , Anti-Bacterial Agents/pharmacology , Drug Resistance, Multiple, Bacterial/drug effects , Humans , Intensive Care Units , Microbial Sensitivity Tests , Nose/microbiology , Reagent Kits, Diagnostic , Rectum/microbiology
17.
Article in English | WPRIM | ID: wpr-144097

ABSTRACT

This study aimed to investigate whether CHROMagar Acinetobacter medium (CHROMagar, France) in combination with an antimicrobial supplement (modified CHROMagar Acinetobacter; CHROMagar, France) can be used for detecting and isolating multidrug-resistant Acinetobacter species (MRA) in nasal and rectal surveillance cultures. Nasal and rectal swab samples were collected from patients in an intensive care unit at a teaching hospital. The samples were used to inoculate modified CHROMagar Acinetobacter plates, which were examined after 24 and 48 hr of incubation at 37degrees C. Their susceptibility against the antimicrobial agents meropenem, imipenem, ciprofloxacin, and amikacin was analyzed using the Etest (bioMerieux, France). A total of 406 paired samples (406 nasal swabs and 406 rectal swabs) were obtained from 226 patients, and 120 samples (28 nasal and 28 rectal cultures, 47 nasal cultures only, and 17 rectal cultures only) yielded MRA. Seventy-five MRA isolates (18.5%) were recovered from the 406 nasal samples, and 45 MRA isolates (11.1%) were recovered from the 406 rectal samples. Of the 120 MRA isolates, 3 (2.5%) were detected only after 48 hr of incubation. The use of modified CHROMagar Acinetobacter together with nasal and rectal swabs and 1-day incubation is an effective surveillance tool for detecting MRA colonization.


Subject(s)
Acinetobacter/drug effects , Acinetobacter Infections/diagnosis , Anti-Bacterial Agents/pharmacology , Drug Resistance, Multiple, Bacterial/drug effects , Humans , Intensive Care Units , Microbial Sensitivity Tests , Nose/microbiology , Reagent Kits, Diagnostic , Rectum/microbiology
18.
Medical Journal of the Islamic Republic of Iran. 2013; 27 (1): 7-11
in English | IMEMR | ID: emr-130576

ABSTRACT

Recto-vaginal colonization of Group B streptococcus [GBS] has been known as an important issue in mother and newborn's health, which is getting frequent in developing countries. Screening test have been introduced and utilized in many countries and is recommended by many researchers. However, due to lack of information in prevalence of GBS, especially in han, there are doubts and controversies regarding whether it is necessary to execute any effort to run screening tests. The aim of this study is to determine the prevalence of positive recto-vaginal culture for GBS in pregnant women between 35-37 weeks of pregnancy in Tehran. In this cross-sectional study, pregnant women in 35[th] 37[th] week of pregnancy were included. All hospitals in Tehran, Iran, were stratified and clustered, and the sampling was done randomly. All recto-vaginal samples were referred to Firoozgar Hospital's pathology laboratory in less than an hour and the results were reported afterwards. Other demographic information and pregnancy and neonatal-related complications such as previous pre-term delivery, PROM [Premature rupture of membrane] and neonatal sepsis and maternal infection were evaluated. The prevalence of positive GBS cultures was 22.76% [234 Out of 1028]. No significant difference was found in positive cultures with mother's age, educational level, and history of pregnancy, maternal complications, and previous neonatal sepsis. Due to similar results with other countries, recto-vaginal GBS culture screening is recommended in Iranian urban pregnant women regarding high prevalence and higher neonatal complication


Subject(s)
Humans , Female , Vagina/microbiology , Pregnancy , Cross-Sectional Studies , Rectum/microbiology , Prevalence , Infant, Newborn, Diseases , Infections , Pregnancy Complications , Sepsis
19.
Rev. argent. microbiol ; 44(2): 89-93, jun. 2012. ilus, tab
Article in Spanish | LILACS | ID: lil-657617

ABSTRACT

Se cultivaron 81 hisopados rectales en el medio CHROMagar KPC y por el método del CDC. Fueron positivos para Klebsiella pneumoniae KPC en CHROMagar KPC, 9/81 y 6/81 con el método del CDC. El medio CHROMagar KPC tuvo dos falsos positivos: 1 K. pneumoniae y 1 Acinetobacter sp. Los falsos positivos del método CDC fueron: 25 Acinetobacter spp., 2 Escherichia coli y4K. pneumoniae. El empleo del medio CHROMagar KPC resultó ser un método con mayor recuperación de aislamientos productores de KPC y menos falsos positivos que el método del CDC. Para evaluar los falsos positivos en el medio CHROMagar KPC se cultivaron 1247 hisopados rectales. Se obtuvieron 1021 negativos, 171 K. pneumoniae KPC y 55 (4,4 %) falsos positivos. Debido al desarrollo de falsos positivos en el medio CHROMagar KPC, se debe confirmar por caracterización fenotípica la presencia de KPC en las bacterias aisladas.


Eighty one rectal swabs (RS) were cultured on CHROMagar KPC and the CDC method. Of the 81 samples, 9 were positive for KPC-producing Klebsiella pneumoniae on CHROMagar KPC, and 6 for the CDC method. CHROMagar KPC had two false positive (FP) results: 1 K. pneumoniae and 1 Acinetobacter sp. FP results on the CDC method were: 25 Acinetobacter spp., 2 Escherichia coli and 4 K. pneumoniae. CHROMagar KPC yielded a better recovery of KPC-producing bacteria and less FP results than CDC method. In order to evaluate FP results on CHROMagar KPC, 1247 RS were cultured and yielded 1021 negatives, 171 KPC-producing K. pneumoniae and 55 FP (4.4 %). Because of the FP results growing on CHROMagar KPC, KPC must be phenotypically confirmed in the bacteria isolated.


Subject(s)
Humans , beta-Lactam Resistance , Bacterial Proteins/analysis , Bacteriological Techniques/methods , Culture Media , Carbapenems/pharmacology , Klebsiella pneumoniae/isolation & purification , Rectum/microbiology , beta-Lactamases/analysis , Agar , Acinetobacter/enzymology , Bacterial Proteins/genetics , Centers for Disease Control and Prevention, U.S. , Chromogenic Compounds , Escherichia coli/enzymology , False Positive Reactions , Klebsiella pneumoniae/drug effects , Klebsiella pneumoniae/enzymology , Klebsiella pneumoniae/genetics , Mass Screening , Phenotype , United States , beta-Lactam Resistance/genetics , beta-Lactamases/genetics
20.
Rev. Soc. Bras. Med. Trop ; 44(5): 631-632, Sept.-Oct. 2011. tab
Article in English | LILACS | ID: lil-602908

ABSTRACT

INTRODUCTION: Laboratory-based surveillance is an important component in the control of vancomycin resistant enterococci (VRE). METHODS: The study aimed to evaluate real-time polymerase chain reaction (RT-PCR) (genes vanA-vanB) for VRE detection on 115 swabs from patients included in a surveillance program. RESULTS: Sensitivity of RT-PCR was similar to primary culture (75 percent and 79.5 percent, respectively) when compared to broth enriched culture, whereas specificity was 83.1 percent. CONCLUSIONS: RT-PCR provides same day results, however it showed low sensitivity for VRE detection.


INTRODUÇÃO: Vigilância com base em detecção laboratorial é um componente importante no controle de enterococos resistentes a vancomicina (ERV). MÉTODOS: Avaliamos procedimento da reação em cadeia da polimerase real time (PCR-RT) (genes vanA-vanB) para detecção de ERV em 115 swabs de pacientes incluídos em um programa de vigilância. RESULTADOS: A sensibilidade do RT-PCR foi semelhante a da cultura primária (75 por cento e 79,5 por cento, respectivamente) quando comparada com a cultura em caldo enriquecido, enquanto a especificidade foi de 83,1 por cento. CONCLUSÕES: O RT-PCR fornece resultados no mesmo dia, contudo mostra baixa sensibilidade para a detecção de VRE.


Subject(s)
Humans , Bacterial Proteins/genetics , Carbon-Oxygen Ligases/genetics , Enterococcus/genetics , Gram-Positive Bacterial Infections/diagnosis , Rectum/microbiology , Vancomycin Resistance/genetics , Enterococcus/isolation & purification , Gram-Positive Bacterial Infections/microbiology , Predictive Value of Tests , Real-Time Polymerase Chain Reaction/methods , Sensitivity and Specificity
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