RESUMEN
ABSTRACT There are limited data on the molecular epidemiology of cryptococcosis in Brazil. Here, we report on the identification of the molecular pattern of the Cryptococcus species that caused meningitis in patients admitted in a Brazilian reference tertiary care hospital, and review the published studies addressing the molecular epidemiology of Cryptococcus in Brazil. Our study has shown the predominance of molecular type VNII in HIV-infected patients with cryptococcal meningoencephalitis. Molecular types VNII and VGII were occasionally detected in HIV-infected and non-infected patients with meningoencephalitis. In contrast, previous studies have shown that several regions exhibited a high prevalence of the VNI molecular type and sporadic cases of the VNII and VGII molecular types in patients with cryptococcosis in Brazil. Additional studies including VNII isolates will contribute to understanding the epidemiology and phylogenetic relationship of these genotype compared to the other ones. So far, no clear correlation has been established between genotypes, antifungal susceptibility for Cryptococcus and clinical outcome in cryptococcosis.
Asunto(s)
Humanos , Masculino , Femenino , Lactante , Adulto , Persona de Mediana Edad , Anciano , Meningitis Criptocócica/microbiología , Cryptococcus neoformans/genética , Polimorfismo de Longitud del Fragmento de Restricción , Brasil/epidemiología , Infecciones por VIH/microbiología , Técnicas de Tipificación Micológica , Meningitis Criptocócica/epidemiología , Epidemiología Molecular , Cryptococcus neoformans/clasificación , Centros de Atención Terciaria , GenotipoRESUMEN
This study determined the prevalence of metallo-â-lactamase (MBL)-producing Pseudomonas aeruginosa in two hospitals located in the Southern part of Brazil and compare the performance of two different phenotypic tests. Thirty-one non-repetitive Pseudomonas aeruginosa isolates from various clinical samples from patients admitted to two hospitals located in Rio Grande do Sul, Brazil (twenty-three from a hospital in Porto Alegre City and eight isolates from a hospital in Vale dos Sinos Region). All strains suggestive of possessing MBLs by phenotypic methods were included in this study. Phenotypic detection of MBLs was carried out simultaneously by using both the MBL Etest® and disk approximation test using 2-mercaptopropionic acid close to a ceftazidime disk. Strains positive were further confirmed using molecular techniques for blaVIM, blaIMP and blaSPM-1. The prevalence of MBLs from samplesof inpatients from the hospital located in Porto Alegre was 30.4 percent and that of inpatients from Vale dos Sinos hospital was only 3.1 percent. Only MBL type SPM-1 was detected in these samples by molecular analysis and all were detected by the Etest® MBL strips. The prevalence of P. aeruginosa that produce MBLs can be markedly different in distinct geographical areas, even among different hospitals in the same area. In our study, the EDTA-based method was the only method able to detect all strains harboring the SPM-1 enzyme.